4 Draft PPQ FA520920R0009.pdf

Attachment 4 Solicitation No. FA520920R0009

MEMORANDUM FOR CONTRACTING ACTIVITY

FROM: 374 CONS/PKS

Unit 5228, Bldg. 620, Yokota Air Base Fussa-shi, Tokyo, Japan

SUBJECT: Past Performance Questionnaire

FOR OFFICIAL USE ONLY (関係者のみ閲覧可)

The 374 CONS/PKS of the United States Air Force, Yokota Air Base, Japan is in the process of competitively selecting a source for Multiple Award IDIQ Japan-wide Office Furniture (Systems and Modular Furniture), Cubicles Furniture, Executive Office and Conference Furniture, and a Variety of Housing/Dorm Furniture Purchase & Installation covering the Areas, Yokota AB, Kadena AB, and Misawa AB, Japan

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. Our schedule is extremely tight and we desire your written response no later than (xx Jun 2020). 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 madison.tikalsky.1@us.af.mil and kiyomi.okamura.jp@us.af.mil.

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.

在⽇⽶軍横⽥基地契約中隊では、⼊札番号、FA520920R0000, 横⽥基地、嘉⼿納基地、ならびに三沢

基地を含めた空軍基地内のオフィス家具の買い付けとその設置、基地内の幹部組織の家具の買い付けと及 びその設置、さらに軍属の⽅々の住宅において使⽤する家具、また独⾝寮等で使⽤する家具の買い付け等に 関する委託業務のための請負業者を選定しております。⼊札審査の⼀環として、⼊札参加業者の「要求され ている家具及びその設置、またデザイン・レイアウト等の業務をを⾏う能⼒」を確認します。その際、貴社のよう な、既にその業者との取引のある発注者からの情報を参考にさせていただいております。質問内容につきまして は、添付のアンケートをご覧ください。お⼿数ではございますが、添付のアンケートを 2020 年 6 ⽉ xx ⽇までに記

Solicitation No. FA520920R0001

⼊をし、当⽅まで送っていただけると幸いです。アンケートに対する回答はワードで作成し、そのまま madison.tikalsky.1@us.af.mi 及び kiyomi.okamura.jp@us.af.mil

までメール送信してください。また、ご質問等ございましたら、いつでも問い合わせていただいて結構です。いただい たアンケートは業者選定の公式書類のひとつとなります。ご協⼒に感謝いたします。

JOSHUA B. GRUBB

Contracting Officer

1 Atch:

Recent (Present)/ Past Performance Questionnaire

RECENT (PRESENT)/PAST PERFORMANCE SURVEY

履⾏履歴調査票

FROM: 374 CONS/PKS

Unit 5228, Bldg 620 Yokota Air Base Fussa-shi Tokyo 197-0001

1. INSTRUCTION: The contractor, who sent this survey, has provided the following project as a reference for their present/past performance. Please provide frank, concise comments regarding your assessment of the contractor’s performance regarding this project. When responding to the descriptive statements, choose the rating that most accurately describes the contractor’s performance or situation.

The ratings correspond with the following descriptive values. In accordance with FAR 15.306(e)(4), the names of individuals providing reference information about an offeror’s past performance shall not be disclosed. 横⽥基地契約中隊では在⽇⽶軍の業務委託契約において応札業者の受注実績とその履⾏内 容を落札の選定基準に加えております。つきましては貴殿の率直で簡潔なご意⾒を頂きたく添付の調査票を お送りした次第です。下記の説明に最も近いと思われる評価を項⽬別にご回答願います。尚、⽶国連邦調 達規則に則り回答者のお名前は公表いたしません。

RATING SCALE 評価の⽬安

(E)xceptional （⾮常に優れている）: Performance meets contractual requirements and exceeds many to the customer’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. 契約内容を満たした上でさらに多くの利益を顧客に与えた。対象となる業務はほとんど問題もなく、 あった場合でも業者の有効な是正措置で問題なく完了した。

(V)ery (G)ood （⼤変満⾜）: Performance meets contractual requirements and exceeds some to the customer’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. 契約内容を満たした上でさらに、⾼い満⾜が得られた｡ 対象の業務に軽微な問題が⽣じても、 業者は有効な是正処置を取って完了した。

(S)atisfactory （満⾜）: Performance meets contractual requirements. The contractual performance of the element or sub-element being assessed contains some minor problems for which corrective actions taken by the contractor were satisfactory. 契約要件は満たしている。履⾏中に軽微な問題が⽣じたが、業 者の是正処置は満⾜であった。

(N)eutral （どちらでもない）: Did not observe performance in this area. 履⾏内容に該当なし。

(M)arginal （不満）： Performance does not meet some contractual requirements. The contractual performance of the element or sub-element reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented. 履⾏は⼀部不完全であった。対象の業務に、業者の是正⼿段の不備による重⼤な ⽋陥がある。業者の改善策は有効でないか⼗分に実⾏されていないと思われる。

(U)nsatisfactory （⼤変不満）: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-elements being assessed reflects a serious problem for which corrective actions were not accomplished. The contractor did not take any corrective actions. 契約内容を満たしておらず、期間内に改善の⾒込みなし。契 約した業務は完了せず、業者は是正処置を怠った。

2. CONTRACT INFORMATION (応札する業者が記⼊): The below listed contractor has identified they provided or are currently providing services for your company/agency.貴殿との委託業務は以下の通 りです。

a. Contractor (Company/Agency) 契約者:

b. Contractor Address/Phone 契約者の住所・電話番号:

c. Prime contractor or subcontract 主契約者 または 再委託契約者 (元請/下請)

d. Title of Program/Contract 契約件名:

1) Contract Number 契約番号:

2) Period of Performance 契約期間:

3) Services/On-Site Work Provided (explain in detail the type of services provided by the contractor)

業務の内容:

e. Total Contract Amount 契約⾦額:

3. RESPONDENT IDENTIFICATION (回答者、評価者が記⼊): (This information will be kept confidential in accordance with FAR 15.306(e)(4). You may be contacted for additional information pertaining to past or present performance of the contractor identified in section 1 above. ご回答の内容は

公表いたしません。審査の⼿続き上、再度連絡を取らせていただく場合がありますので、ご理解、ご協⼒お願 いします。

a. Company’s Name 会社名:

b. Name and Title お名前と役職:

c. Phone Number 電話番号: _______________ FAX ファックス: ______________

E-mail Address 電⼦メールアドレス： ＿＿＿＿＿＿＿＿＿＿＿

d. Address 住所: _________________________________________

e. Relationship to Project 契約案件における地位：

f. Length of Involvement in Project 契約案件の担当年数: ______________

g. Date Questionnaire Completed 回答⽇: ___________

4. QUESTIONNAIRE 調査票 (Circle One いずれかに｢｣を付けてください)

a. (Quality of Work) Were you satisfied with the quality of service/work performed or items supplied? E VG S N M U

提供されたサービスや商品の満⾜度のいかがでしたか？

b. (Quality of Work) How effective did the contractor’s quality control and/ E VG S N M U or inspection procedures operate ?

品質管理と作業上の検査⼿順は妥当でしたか？ c.

(Timely Performance/Schedule) Did the contractor provide the required service/work in a timely manner and on schedule?

E VG S N M U

契約者の作業は迅速で予定の納期に間に合いましたか？

d. (Effectiveness of Management for Resolution of Issues, Problems, and Customer Complaints) How well did the contractor resolve Issues/ Problems/Customer Complaints, if any?

契約者は作業上の懸案、問題解決、苦情処理に⻑けていましたか？

e. (Compliance with the Applicable Rules, Regs, Laws, including

Safety Standards) How efficient was the contractor in abiding by all Rules, Regs, Laws, and Safety Standards?

契約者の作業は関連する全ての法規や安全基準を守っていましたか？

f. Would you hire this contractor again? If no, why? YES NO

機会があれば、またこの業者に依頼したいですか？「いいえ」の場合は理由をお聞かせください。

g. Overall Rating 総合評価: E VG S N M U

h. Additional Comments/Remarks その他:

Please e-mail completed questionnaires to the address shown below:

ご回答後、下記電⼦メールアドレスへご返送の程よろしくお願いいたします。

374 CONS/PKS

Unit 5228, Bldg 620 Yokota Air Base Fussa-shi Tokyo 197-0001 Attn: Madison Tikalsky and Kiyomi Okamura

E-mail: madison.tikalsky.1@us.af.mil and kiyomi.okamura.jp@us.af.mil

〒197-0001

東京都 福⽣市 在⽇⽶軍 横⽥基地内

建物番号 620, 374 契約中隊 (PKS 特殊契約課)

電⼦メール： madison.tikalsky.1@us.af.mil and kiyomi.okamura.jp@us.af.mil