Attach 5 - Past Performance Questionnaire - 2 MAR 2020.docx

FA300220R0007

Section J – Attachment 5

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

1. The contractor listed below is being considered in a Source Selection by the Air Education and Training Command 338th Specialized Contracting Squadron, Joint Base San Antonio-Randolph, TX. You have received this questionnaire because you have been identified as a source of Past Performance Information for that offeror. Any comments you can provide regarding the past performance of the contractor providing this form is greatly appreciated.

2. Please complete the attached questionnaire for the contractor and program described in Section one (1) below (to be completed by the offeror) based on the following guidance. Send the completed questionnaire to Stephani Preusser, Melody Taylor and Cory Ostrowski via e-mail at Stephani.Preusser.1@us.af.mil, Melody.taylor@us.af.mil, cory.ostrowski.1@us.af.mil . Do not send the completed questionnaire to the contractor. We appreciate your help.

PLEASE FILL IN ALL SECTIONS. STATE “NOT APPLICABLE” IF QUESTION DOES NOT APPLY OR YOU HAVE NO COMMENT. YOUR PROMPT RESPONSE WILL BE ONE OF THE KEYS TO THE SUCCESSFUL AND TIMELY COMPLETION OF THE SOURCE SELECTION.

3. Indicate a rating, based on the description below, for the contractor’s performance on the identified program. Underline the selected rating. Assessments should reflect only contractor liable performance. The following is a definition of the rating levels.

Exceptional

EX

Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good

VG

Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory

SAT

Performance meets contractual requirements. The contractual performance of the element being assessed contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal

MAR

Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s actions appear only marginally effective or were not fully implemented.

Unsatisfactory

UNS

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Not Applicable

NA

Unable to provide a score. Performance in this area is not applicable to the effort assessed.

4. Please provide narrative explanations to support your ratings particularly for high or low ratings. Space for your remarks is provided after each area.

5. In addition to completing the attached questionnaire for the identified program, please provide comments on any other programs for which your activity has contracts with this contractor. You are urged to supplement your own knowledge of the contractor’s performance with the judgment of others in your organization.

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: ________________________________________________________________________________

B. Cage Code of contractor contract was awarded to: _________________________________

C. Contract number: _______________________________________

D. Contract type: ______________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance: _________________________________________________________

G. Initial contract cost: $____________________________

H. Current/final contract cost: $_______________________________

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name: ______________________________________________________________________________

B. Customer or agency description (if applicable): _______________________________________________________________

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

D. Reasons for differences between initial contract cost and final contract costs: ____________________________

E. Description of service provided ________________________________________________________________

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name: ______________________________________________________________________________________ B. Evaluator's title: ______________________________________________________________________________________ C. Evaluator's phone/fax number: ___________________________________________________________________

Number of years evaluator worked on subject contract: _____________________

SECTION 4: EVALUATION

Fire & Emergency Services (F&ES)

1. Demonstrates capabilities in processing and the dispatch of all requests for emergency assistance from voice and automated receiving devices; processing and forwarding of routine administrative calls and notifications 24 hours a day, 7 days a week.

2. Demonstrates capabilities in responding with the required number of qualified personnel and appropriate equipment to all fires, fire alarms, aircraft incidents, automobile accidents, hazardous material incidents, rescues, Emergency Medical Service (EMS) incidents and miscellaneous fires/emergency situations.

3. Demonstrates capabilities to perform emergency medical responses IAW governmental leadership (or equivalent), regulations and EMS protocols.

4. Demonstrates capabilities in maintaining F&ES vehicles in a safe and serviceable condition IAW standards.

Network and Information Technology (IT) Infrastructure

5. Demonstrates capabilities in operating, maintaining, and repairing the IT infrastructure that supports internal and external connectivity.

Civil Engineering

6. Demonstrates capabilities to respond to high priority work requests immediately to complete/eliminate the situation or downgrade the work order priority classification.

7. Demonstrates capabilities to meet removal of debris, snow and ice from paves areas including streets, airfields, walkways, parking lots and other similar surfaces.

8. Demonstrates capabilities to manage and direct construction projects from design to completion using cradle-to-grave concepts.

9. Demonstrates capabilities to perform construction inspections for facility projects performed on the installation and associated properties.

10. Demonstrates capabilities to ensure environmental compliance aspects of civil engineering water programs.

Logistics

11. Demonstrates capabilities to manage warehouse functions to include storage and accounting for in-warehouse supply and equipment.

12. Demonstrates capabilities to maintain a robust, reliable & safe fleet of vehicles capable of fulfilling performance requirements, ensuring vehicles are operable, safe & ready for use IAW standardized fleet readiness capability.

Program Management and Staffing Approach

13. Demonstrates capabilities to recruit, train and maintain qualified and/or certified personnel required to perform from the first day of contract operation.

14. Demonstrates capabilities to provide vehicles and equipment available on the first day of the contract and remain available for the life of the contract to meet requirements.

15. Demonstrates capabilities to meet contract requirements.

16. Demonstrates capabilities to provide effective overall contract management (including ability to effectively lead, manage and control the program).

Comments:

Overall, how satisfied are you with the contractor’s performance?

Comments:

Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Yes___ Default___ Convenience___ Pending Terminations___ No ___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

Please provide any additional comments concerning this contractor’s performance, as desired.

Evaluator’s Name

Evaluator’s Phone Number

Evaluator’s Email

Evaluator’s Signature Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Email: Stephani.Preusser.1@us.af.mil, Melody.taylor@us.af.mil, cory.ostrowski.1@us.af.mil