05a. ATTCH 05a - Past Performance Questionnaire.pdf

Past Performance Questionnaire

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does and notify the Contracting Officer. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated time frame.

Rating Definitions:

Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.

Limited Confidence: Performance does not meet some contractual requirements.

Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective. The offeror has had little success performing the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor’s name cited above):

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

Attachement 5a - Past Performance Questionnaire

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

Email Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Customer Service: (business relations, staff appearance, problem resolution)

Substantial Confidence

Satisfactory Confidence

Limited Confidence

No Confidence

Rationale:

B. Quality of Meals: (food used, meal temperature, storage containers)

Substantial Confidence

Satisfactory Confidence

Limited Confidence

No Confidence

Rationale:

C. Adherence to schedule: (flexibility in scheduling, timeliness of meal delivery)

Substantial Confidence

Satisfactory Confidence

Limited Confidence

No Confidence

Rationale:

D. Adherence to menus (did they deviate from menus prior to approval)

Substantial Confidence

Satisfactory Confidence

Limited Confidence

No Confidence

Rationale:

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

Substantial Confidence

Satisfactory Confidence

Limited Confidence

No Confidence

Rationale:

F. General Comments. Provide any other relevant performance information.

Comments:

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Point of Contact (Name):

Point of Contact (Telephone Number):

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Address:

Telephone Number:

Email Address:

Date:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Points of Contacts listed below no later than September 28, 2026.

Contract Specialist:

Hunter Maeder

(515) 252-4170 hunter.d.maeder.civ@army.mil

Contracting Officer:

Kelsey Letcher

(515) 252-4508 kelsey.l.letcher.civ@army.mil

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