Atch 6_Past Performance Questionnaire.docx

CUI

When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

FA462525Q1004, Attachment 6 – Past Performance Questionnaire The 509th Contracting Squadron of the Air Force Global Strike Command is in the process of competitively selecting a source for VTE Elevator Maintenance Services on Whiteman AFB.

One of the considerations in proposal evaluation is the verification of the offerors’ past performance on contracts or other work efforts which reflect the offerors’ 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 offerors’ performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to: volcious.shelton@us.af.mil and amanda.fragoso@us.af.mil (Attn: A1C Volcious Shelton, Amanda Fragoso). Please call A1C Volcious Shelton at 660-687-2945 or Amanda Fragoso at 660-687-3668 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.

Amanda Fragoso Contracting Officer

Attachment Past Performance Questionnaire

Controlled By: 509 Bomb Wing Controlled By: 509th Contracting Squadron CUI Category: PROCURE Distribution/Dissemination Controls: FED ONLY POC: Amanda Fragoso, amanda.fragoso@us.af.mil, 660-687-3668

Section 1: Contract Identification

3. Reasons for difference (if applicable):

Click or tap here to enter text.

H. Description of work performed:

Type description of work here.

Section 2: Customer or Agency Identification

Section 3: Respondent Identification

Section 4: Performance Information

In the table 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.

1. Developed and maintained a cooperative and productive professional working relationship through all phases of the contract.

Comments:

2. Provided licensed, experienced technicians needed to meet contract requirements.

3. Maintained sufficient staffing and equipment to complete the work in an effective and efficient manner for the duration of the contract.

4. Kept/Provided a full and comprehensive record of all required actions, as required by the terms of the contract.

5. Demonstrated the ability to complete work in a safe and timely manner.

6. Promptly, identified problems, hazardous material, or other site issues to the Agency.

7. Corrected deficiencies in timely manner and corrective action was effective.

8. Paid all employees, subcontractors, and suppliers as required by the terms of the contract.

9. Discarded all waste or hazardous material in accordance with state, federal, local, and environmental procedures/regulations.

10. Provided and used the proper personal protective equipment (PPE) for all work in accordance with OSHA regulations.

11. Provided suggested solutions for the Agency’s consideration and partnered with the Agency to find cost effective solutions to issues encountered during the course of work.

12. How would you rate the contractor’s overall performance on this contract?

13. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.

☐ Yes ☐ No

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

EXPLANATION:

☐ Yes ☐ No

Additional remarks (these are important; please include comments):

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

E-Mail to: volcious.shelton@us.af.mil & amanda.fragoso@us.af.mil (Attn: A1C Volcious Shelton, Amanda Fragoso) CUI Page 2 of 6