ATTACHMENT #5 PAST PERFORMANCE QUESTIONNAIRE.pdf

693KA9-18-R-00001 HEADQUARTERS FITNESS AND WELLNESS SERVICES

PAST PERFORMANCE QUESTIONNAIRE – ATTACHMENT # 5

In accordance with SIR Section L.13, Past Performance will be evaluated as a stand-alone Technical Factor. Offerors must provide past performance information for a minimum of two (2) contracts, of similar size, type, scope within the past three years for the work required by the SOW. Offerors may provide a maximum of four Past Performance references. Offerors must provide their completed Questionnaires with their proposal packages. Based on the information provided in the Questionnaire, the

Government will contact and interview the Offerors’ Past Performance contacts to determine their overall Past Performance ratings. Offerors Past Performance rating will be impacted if the Offeror fails to provide and/or, if the Government is unable to obtain information, for the Offerors Past Performance references for a minimum of two (2) contracts of similar size and scope

(refer to SIR Section M8). The Government will document and evaluate offerors Past Performance in accordance with AMS

T3.2.2A(3) Past Performance. If the Government receives negative information that would have a significant effect on the likelihood of an award to an offeror, then the Government will disclose that information and provide the offeror an opportunity to respond. Questionnaires may be submitted for prime and sub-contracting past performance experience. Past Performance information must be provided for at least one contract where the contractor was the Prime Contractor. The FAA reserves the right to collect additional past performance information from other sources. Offeror’s must include the listed information in their past performance information:

OFFEROR ______________________________________________________________________________________

Offeror’s past performance submissions must include the following information:

a. Customer_________________________________________________________________________________________

b. Address, telephone number, e-mail of Contracting Officer (or equivalent) or the Contracting Officer’s Representative in charge of project: _______________________________________________________________________________________________

c. Contract number:________________________________________________________________________________________

d. Date of contract, period of performance, and place(s) of performance:______________________________________________

e. Size of contract or relevant task order (average number of staff and dollar value): _____________________________________

f. Narrative description of the project that describes the scope of work, the specific responsibilities of the offeror demonstrating relevance to the current SIR requirements, and any problems or issues that occurred and the corrective action taken that may impact the Offeror’s past performance:

g. Role (prime or subcontractor):______________________________________________________________________________

HOW DID YOUR CUSTOMER RATE YOUR PAST PERFORMANCE? ______ ______ _____

0/Unacceptable 1/Acceptable 2/Excellent