Atch 5_PPQ Form Paramedic Services.docx

FA483022QS001

Attachment 5

PRESENT / PAST PERFORMANCE EVALUATION QUESTIONNAIRE PARAMEDIC SERVICES, MOODY AFB, GA

SOLICITATION NO: FA483022QS001

FORM COMPLETION INSTRUCTIONS: Please complete questionnaire by typing for legibility purposes, and email the results to the Contracting Specialist, SrA Jordon Bongcayao at jordon.bongcayao@us.af.mil and to the Contracting Officer, Gerard Entwisle at gerard.entwisle.2@us.af.mil. Please submit completed questionnaire via email.

Please direct questions to SrA Bongcayao at 229-257-3676 or Gerard Entwisle at 229-257-2509. Your Participation is greatly appreciated.

PLEASE RETURN NO LATER THAN: 20 January 2022, at 2:00 PM (Eastern Standard Time)

Your assistance is respectfully requested in providing information on the attached performance questionnaire. The importance of your opinion cannot be overstated. This survey measures the present/past performance of the prospective Contractor for providing Paramedic Services at Moody AFB, GA.

Name and Address of Contractor questionnaire is being completed for:

Point of Contact/Email Address/Phone Number:

CAGE Code:

DUNS Number:

Contract Number:

Contract Type:

Performance Period (base plus any options):

Total Contract Dollar Value:

Description of Services Performed:

Contractor Performed As:

Prime

Subcontractor

Joint Venture Team Member

Is performance on this contract being reported in CPARS:

Yes

No

Name of Agency/Company completing questionnaire:

Name/Title of person completing questionnaire:

Phone number/email of person completing questionnaire:

Date questionnaire is being completed:

RATING SCALE: Please use the following ratings to answer the questions on pages 2-4.

NOTE: For any ratings less than satisfactory rating, please provide explanation in Remarks section below.

CONTRACTOR PAST PERFORMANCE EVALUATION SURVEY FOR SERVICES

1.)Management Effectiveness:

a. Contractor provided experienced managers and supervisors with technical and administrative abilities to meet contract requirements.

b. The Contractor provided qualified personnel in accordance with the terms and conditions of the contract requirements.

c. Recruited, placed and retained qualified personnel with minimal disruption for hard-to-fill (specialty) positions.

d. The Contractor utilized personnel that were appropriate to the effort performed.

e. Contractor demonstrated effective management over the effort performed.

f. Contractor maintained an open line of communication so that the Contracting Officer’s Representative (COR) and/or Contracting Officer were apprised of any schedule issues.

g. Contractor demonstrated effective management of its subcontractor(s) and or teaming partner as it relates to the contract.

h. Contractor’s overall management effectiveness.

PLEASE PROVIDE COMMENTS ON LAST PAGE IF RATED ABOVE OR BELOW SATISFACTORY

2.) Quality of Service and Workmanship:

a. Contractor provided professional staff.

b. Contractor maintained quality of staff care.

c. Contractor provided complete and accurate qualifying documentation for contractor personnel in accordance with the terms and conditions of the contract.

d. Tasks required under this effort were performed in a timely manner and in accordance with the period of performance of the contract.

e. Contractor presented information and correspondence in a clear, concise, and businesslike manner.

g. Contractor promptly notified the COR and/or Contracting Officer in a timely manner regarding urgent issues.

PLEASE PROVIDE COMMENTS ON LAST PAGE IF RATED ABOVE OR BELOW SATISFACTORY

3.) Manpower Efficiencies

a. Contractor provided new hires in a timely manner

b. Labor turnover in key personnel labor categories was minimal and did not adversely affect Contractor performance.

c. Contractor proposed qualified personnel to fulfill the requirements of the contract without frequent turnover and minimal operation disruption.

d. Contractor illustrated the capability to manage large workforce at one location (25+ employees)

PLEASE PROVIDE COMMENTS ON LAST PAGE IF RATED ABOVE OR BELOW SATISFACTORY

4.) Quality Control

a. Contractor provided an adequate quality control plan.

b. Contractor adhered to its quality control plan.

c. Contractor documented its quality control checks/corrective actions.

d. Contractor cooperated with the Government in providing flexible, proactive, and effective recommended solutions to critical program issues.

e. Contractor demonstrated ability to adequately address performance problems.

f. Contractor’s overall quality control.

PLEASE PROVIDE COMMENTS ON LAST PAGE IF RATED ABOVE OR BELOW SATISFACTORY

5.) Customer Satisfaction

a. Services provided adequately met the needs of the program.

b. Contractor was able to perform with minimal direction from the COR or the Contracting Officer.

c. Contractor's reasonableness, cooperation, and commitment to customer satisfaction.

d. I am satisfied with the performance of the Contractor under this effort.

PLEASE PROVIDE COMMENTS ON LAST PAGE IF RATED ABOVE OR BELOW SATISFACTORY

PERFORMANCE SUMMARY:

Would you award this firm another contract? Yes No

If you answered No provide an explanation in the additional comments section

ADDITIONAL COMMENTS: