10 - Past Performance Questionnaire - Wacky World Playground.pdf

For Official Use Only When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

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Section J Attachment: Past Performance Questionnaire

The 87th Contracting Squadron is in the process of competitively selecting an 8(a) Small Business source for the procurement of Wacky World Playground Delivery and Installation, New Jersey. The Wacky World Playground Services requirement consists of but is not limited to, the following: preparing area for installation, delivery of required equipment and installation of all playground equipment. In addition, the contractor shall perform services outlined in accordance with the Statement Of Work (SOW).

One of the considerations in proposal evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your completed questionnaire no later than 3PM EST on Wednesday May 1st , 2024. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to jeremiah.fontenot@us.af.mil. Please email Jeremiah Fontenot if you have any questions. Your completed questionnaire will become a part of the official Source Selection records.

Your assistance is greatly appreciated, and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

KELSEY BRODBINE

CONTRACTING OFFICER

1 Attachment :

Past Performance Questionnaire with Cover Letter http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5836 mailto:jeremiah.fontenot@us.af.mil.

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Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date through

2. Current Schedule (assuming all options exercised):

Beginning Date through

3. Reason for difference (if applicable):

I. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? ☐ Yes ☐No

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

Note: If offeror holds or has held other contracts with your agency/organization in the last three (3) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602

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C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / e-mail address:

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

E. Other suggested points of contact:

Section 4: Performance Information

In the tables below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the

Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

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N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

The Contractor: E V S M U N/A

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

SUPPORTING INFORMATION:

2. Demonstrated the ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

6. Provided effective quality control and/or inspection procedures to meet contract requirements.

7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

Note: The following are SAMPLE questions. Past Performance evaluation teams MUST construct a simple and concise Past Performance Questionnaire, tailored to seek out key information tied to the significant aspects of the planned acquisition. Avoid questions that can be answered with a “yes” or “no” but instead include probing and direct questions to draw out the required information desired.

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The Contractor: E V S M U N/A

8. Provided timely resolution of contract discrepancies.

9. Identified problems as they occurred.

10. Suggested alternative approaches to problems.

11. Displayed initiative to solve problems.

12. Developed realistic progress schedules.

13. Met established project schedules.

14. Provided timely resolution of warranty defects.

15. Was responsive to contract changes.

16. Provided adequate project supervision.

Section J Attachment: Past Performance Questionnaire

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The Contractor: E V S M U N/A

17. Obtained consent of surety for increases in bonding as work-in-progress increased.

SUPPORTING INFORMATION:

18. Paid subcontractors/suppliers in a timely manner.

SUPPORTING INFORMATION:

19. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

SUPPORTING INFORMATION:

20. Cooperated with Government personnel after award.

SUPPORTING INFORMATION:

21. Met or exceeded small business and small disadvantaged business goals set forth in the approved subcontracting plan.

SUPPORTING INFORMATION:

22. How would you rate the contractor's overall performance on this contract?

SUPPORTING INFORMATION:

23. Was the contractor ever issued a cure or show cause notice under the referenced contract?

If yes, explain.

EXPLANATION:

☐ Yes

☐ No

24. Would you award another contract to this contractor? If not, explain.

EXPLANATION:

☐ Yes

☐ No

Section J Attachment: Past Performance Questionnaire

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IF THIS WAS A GOVERNMENT CONTRACT:

Did this contract include FAR 52.219-9, Small Business Subcontracting Plan?

☐ Yes ☐ No

If yes, did the contractor comply with the clause? Please explain.

Did this contract include FAR 52.219-8, Utilization of Small Business Concerns?

☐ Yes ☐ No

If yes, did the contractor comply with the clause? Please explain.

Additional remarks:

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Jeremiah Fontenot at jeremiah.fontenot@us.af.mil &

Kelsey Brodbine at kelsey.brodbine@us.af.mil

PLEASE DO NOT SEND THIS QUESTIONAIRRE BACK

TO SUBJECT CONTRACTOR

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5836 mailto:jeremiah.fontenot@us.af.mil mailto:kelsey.brodbine@us.af.mil

For Official Use Only Page 8 of 8 mailto:erin.schoenenberger@us.af.mil mailto:kelsey.brodbine@us.af.mil