Att 3 Past Performance Questionnaire.docx

21ST CONTRACTING SQUADRON PERFORMANCE QUESTIONNAIRE

Attachment 3 In response to RFQ: FA2517-21-Q-0005

The 21st Contracting Squadron is conducting a competitive acquisition. The offeror has identified you as a reference to validate past performance.

Please complete the following questionnaire to assist in our evaluation of the Contractor’s past performance, and return via email in PDF format no later than 12:00pm MST on 21 January 2021 to the Contracting Officer, amanda.davidson.5@spaceforce.mil and Contract Specialist, oscar.loveless.2@spaceforce.mil.

RESPONDENT INFORMATION:

Contracting Activity/Customer:

Point of Contact (POC):

Title of POC:

Telephone:

Email:

OFFEROR’S REFERENCE INFORMATION:

Contractor Name:

Point of Contact (POC):

Telephone Number:

Email:

CONTRACT INFORMATION:

Contract Number:

Task Order Number:

Type of Contract:

Performance Period: (Base plus any options):

Description of Services:

MAGNITUDE

Annual Contract Value:

Total Contract Dollar Value:

Contractor performed on this contract as:

Please refer to the following table for definitions to assess the Relevancy of the Contractor’s performance:

Relevant - Relevant is defined as a present or past performance effort in providing pick-up, replacement and delivery of at least twenty (20) laundered items such as industrial work uniforms, clean room apparel, treated mops, mats, etc. for at least two (2) facilities.

Not Relevant – Not Relevant is defined as not having a present or past performance effort in providing pick-up, replacement and delivery of at least twenty (20) laundered items such as industrial work uniforms, clean room apparel, treated mops, mats, etc. for at least two (2) facilities.

Relevancy Rating

Please rate the relevancy of this contract using the definitions identified above

Please refer to the following assessment definitions to assess the Contractor’s performance in each of the areas listed in this questionnaire:

(E) Exceptional - The contractor’s performance meets contractual requirements and exceeds performance requirements to the Government’s benefit.

(S) Satisfactory - The contractor’s performance meets contractual requirements and meets performance requirements.

(M) Marginal - The contractor’s performance does not meet some contractual requirements and reflects serious problems under performance requirements.

(U) Unsatisfactory - The contractor’s performance does not meet contractual requirements.

(N) Not Applicable – Unable to provide a rating.

Floor Mat Cleaning Services (Schedule)

Did the contractor perform timely cleaning services required as scheduled?

If other than Yes or “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Floor Mat Cleaning Services (Management)

Did the contractor adequately manage the required cleaning services?

If other than Yes or “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Floor Mat Cleaning Services (Quality)

Did the contractor provide quality cleaning services required throughout the entire performance period(s)?

If other than Yes or “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Would you award this firm another contract:

If you answered “No” provide an explanation:

Was the contract terminated for default or cause:

If you answered “Yes” provide an explanation:

Additional Comments:

Signature: _________________________________________ Date: __________________

Print Name: ________________________________________

Title: ______________________________________________

Telephone: _________________________________________

Thank you for your participation in providing a detailed and accurate history of past performance for this offeror.

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