Attachmen L-02 Past Performance Questionnaire.pdf
PDF 506 KB Posted
- Attached to
- MAHG25-1039 Replace Triangle Pool Liner
- Solicitation number
- FA301026Q0015
About this file
This is a Past Performance Questionnaire template for federal contract solicitation FA301026Q0015 issued by the 81st Contracting Squadron at Keesler Air Force Base, Mississippi, for the repair of the Triangle Pool. The questionnaire must be completed by references listed by offerors and submitted directly to the Contracting Officer (Tiffany Aultman at tiffany.aultman@us.af.mil) from a corporate or government email account concurrent with proposal submission.
The questionnaire requests information from the reference regarding the contractor's past performance on a previously or currently performed contract. References must identify a primary point of contact and alternate point of contact, along with contact details. The evaluation section assesses contractor performance across five categories—Quality, Schedule, Management, and Regulatory Compliance—each using a six-point rating scale: Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, and Not Applicable. Each category includes definitions explaining performance thresholds and requires detailed explanatory comments. The questionnaire concludes with an overall rating of the contractor's performance. References must provide the contract number, contract value including modifications, period of performance, and a brief description of work performed under the referenced contract.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
Solicitation No. FA301026Q0015
Please complete this questionnaire and email to: tiffany.aultman@us.af.mil
We are currently preparing our proposal for the 81st Contracting Squadron, Keesler AFB, MS, Solicitation Number: FA301026Q0015 for the repair of the Triangle Pool. As part of our offer, we have listed you as a reference on our performance for this type of service with your agency or company under the previous or ongoing contract listed below. Your input on our performance is therefore requested.
This Questionnaire is due with the proposal submission. The Questionnaire must be submitted directly to the Contracting Officer from a corporate or government email account.
If you will be unavailable on for verification (if necessary) of this past performance evaluation, please indicate another point of contact (POC) for the Contracting Officer to contact.
Thank you.
POC/Alternate POC Name:
POC/Alternate POC Phone Number:
POC/Alternate POC Email Address:
Name of Offeror:
Phone Number:
Email Address:
CONTRACT REFERENCED
Contract Number (including Task Order number if applicable):
Contract Value (including all modifications):
Period of Performance:
Name of Person Completing Questionnaire:
Agency/Company:
Title:
Phone:
Email:
Attachment L-01
Brief Description of Work Required in the Referenced Contract:
EVALUATION
Please rate the contractor utilizing the guide below. Explanatory narratives giving specific details would be appreciated. Attach additional pages if more space is needed. Evaluation Definitions:
The following definitions should be used in assessing Contractor performance.
Exceptional: Performance EXCEEDS MANY contractual requirements. Performance being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
Very Good: Performance EXCEEDS SOME contractual requirements. Performance being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Satisfactory: Performance MEETS contractual requirements. Performance being evaluated contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
Marginal: Performance MEETS SOME contractual requirements. Performance reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginal effective or were not fully implemented.
Unsatisfactory: Performance DOES NOT MEET contractual requirements. Performance contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
Not Applicable (N/A): Performance information is not recent or relevant as defined in the solicitation. Unable to provide assessment.
PAST PERFORMANCE EVALUATION
QUALITY
What is your assessment of the Contractor’s ability to meet work requirements and the overall quality of the work?
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Quality of Work
Comments:
SCHEDULE
What is your assessment of the Contractor’s ability to provide end-products timely?
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Timeliness Ability to Resolve Timeliness Problems
Comments:
MANAGEMENT
What is your assessment of the Contractor’s ability to manage all aspects of the work?
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Managing Work Aspects
Comments:
REGULATORY COMPLIANCE
What is your assessment of the Contractor’s ability to meet all regulatory requirements? Examples would include safety regulations, Davis-Bacon Act and other labor standards.
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Complying with Regulations
Comments:
OVERALL RATING OF CONTRACTOR’S PERFORMANCE
What is your overall rating of the Contractor’s performance on the contract being assessed.
Exceptional Very Good Satisfactory Marginal Unsatisfactory
General Comments:
| We are currently preparing our proposal for the 81st Contracting Squadron Keesler AFB MS Solicitation: |
| POCAlternate POC Name: |
| POCAlternate POC Phone Number: |
| POCAlternate POC Email Address: |
| Name of Offeror: |
| Phone Number: |
| Email Address: |
| Contract Number including Task Order number if applicable: |
| fill_10: |
| Period of Performance: |
| Name of Person Completing Questionnaire: |
| AgencyCompany: |
| Title: |
| Phone: |
| Email: |
| Brief Description of Work Required in the Referenced Contract: |
| Exceptional: |
| Very Good: |
| Satisfactory: |
| Marginal: |
| Unsatisfactory: |
| Not Applicable NA: |
| ExceptionalQuality of Work: |
| Very GoodQuality of Work: |
| SatisfactoryQuality of Work: |
| MarginalQuality of Work: |
| UnsatisfactoryQuality of Work: |
| NAQuality of Work: |
| CommentsRow1: |
| ExceptionalTimeliness: |
| Very GoodTimeliness: |
| SatisfactoryTimeliness: |
| MarginalTimeliness: |
| UnsatisfactoryTimeliness: |
| NATimeliness: |
| ExceptionalAbility to Resolve Timeliness Problems: |
| Very GoodAbility to Resolve Timeliness Problems: |
| SatisfactoryAbility to Resolve Timeliness Problems: |
| MarginalAbility to Resolve Timeliness Problems: |
| UnsatisfactoryAbility to Resolve Timeliness Problems: |
| NAAbility to Resolve Timeliness Problems: |
| CommentsRow1_2: |
| ExceptionalManaging Work Aspects: |
| Very GoodManaging Work Aspects: |
| SatisfactoryManaging Work Aspects: |
| MarginalManaging Work Aspects: |
| UnsatisfactoryManaging Work Aspects: |
| NAManaging Work Aspects: |
| CommentsRow1_3: |
| ExceptionalComplying with Regulations: |
| Very GoodComplying with Regulations: |
| SatisfactoryComplying with Regulations: |
| MarginalComplying with Regulations: |
| UnsatisfactoryComplying with Regulations: |
| NAComplying with Regulations: |
| CommentsRow1_4: |
| ExceptionalRow1: |
| Very GoodRow1: |
| SatisfactoryRow1: |
| MarginalRow1: |
| UnsatisfactoryRow1: |
| General CommentsRow1: |
| undefined: |
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