Attachment 12 FA480324R0004_Past Performance Questionnaire.pdf

FA480324R0004

Attachment 12

* PAST PERFORMANCE QUESTIONNAIRE

MEMORANDUM FOR WHOM IT MAY CONCERN

FROM: 20 CONS/PKA

321 CULLEN ST.

SHAW AFB SC 29152-5105

Subject: Request for Performance Information, Solicitation#FA480324R0004, Packing, Containerization and Local Drayage of Direct Procurement Method (DPM) Personal Property Shipments

1. One of the integral considerations in proposal evaluations is the verification of the offeror's past performance on contracts, which reflect the offeror's ability to perform on the proposed effort. This effort, solicitation number FA480324R0004, is for Packing, Containerization and Local Drayage of Direct Procurement Method (DPM) Personal Property Shipments, Shaw AFB, SC. We depend upon information received from agencies such as yours, which have had firsthand experience with the offeror, for the evaluation of their performance. Therefore, we request that the attached questionnaire be completed concerning the offeror's present/past performance.

2. Our areas of interest are summarized in the enclosed questionnaire. You are urged to submit your comments on similar programs for which your activity has contracts or administers contracts with the offeror. Any additional information that you think would benefit Shaw AFB, SC in our evaluation of the offeror’s proposals would be appreciated. Please note we may contact the offeror on problem areas or concerns identified to see what corrective actions have been taken or will be taken.

3. Your Past Performance questionnaire(s) are to be completed and returned by: 2:00 PM EST on 9 May 2024 to:

20th CONS/PKA Attn: hgaunannette Watson 321 Cullen St. Shaw AFB SC 29152-5105

Mark documents "SOURCE SELECTION SENSITIVE/FOR OFFICIAL USE ONLY" Completed questionnaires may be emailed to shaunannette.watson@us.af.mil

4. If additional information is required, please contact, Shaunannette Watson at shaunannette.watson@us.af.mil (803) 895-5396, or Jason Hibb at jason.hibbs@us.af.mil or (803) 895-9821.

JASON S. HIBBS

Contracting Officer mailto:nancy.hunt@us.af.mil mailto:daniel.kane.8@us.af.mil

ATTACHMENT 6

CONTRACTOR’S NAME: ____________________ CONTRACT NUMBER______________

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: ____________________ Address: __________________________ Telephone Number: ____________________ __________________________ Fax Number: ____________________ __________________________ Point of Contact: ____________________ Project Title or Brief Description of Work: ________________________________________ Contract Number Provided by Offeror: ________________________________________ Dollar Amount: $ ________* Contract Period or Dates of Performance Provided by Offeror: __________________________* *Note: If offeror holds or has held other contracts with your agency/organization in the last 5 years, please complete separate evaluation forms for those contracts as well.

Contractor performed as the � Prime Contractor � Sub-Contractor � Key Personnel.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ____________________________ Address: _____________________ Telephone Number: ___________________ _____________________________ Fax Number: _____________________ _____________________________ Email Address: _____________________

C. FAX COMPLETED SURVEY FORM TO: ____________________________________

D. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A

NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

1 2 3 4 5

NO CONFIDENCE LIMITED

CONFIDENCE

SATISFACTORY

CONFIDENCE

SUBSTANTIAL

CONFIDENCE

UNKNOWN

CONFIDENCE

Based on the offeror’s performance record, the government has no expectation that the offeror will be able to successfully perform the required effort.

Based on the offeror’s performance record, the government has a low expectation that the offeror will successfully perform the required effort

Based on the offeror’s performance record, the government has an expectation that the offeror will successfully perform the required effort.

Based on the offeror’s performance record, the government has a high expectation that the offeror will successfully perform the required effort.

No performance record is identifiable.

ATTACHMENT 6

CONTRACTOR’S NAME: ____________________ CONTRACT NUMBER______________

The contractor: 1 2 3 4 5

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

1 2 3 4 5

2. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

1 2 3 4 5

3. Delegated authority to project managers and supervisors Commensurate with contract requirements.

1 2 3 4 5

4. Home office participated in solving significant local problems.

1 2 3 4 5

5. Followed approved quality control plan. 1 2 3 4 5

6. Provided effective quality control and/or inspection procedures to meet contract requirements.

1 2 3 4 5

7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

1 2 3 4 5

8. Provided timely resolution of contract discrepancies. 1 2 3 4 5

9. Identified problems as they occurred. 1 2 3 4 5

10. Suggested alternative approaches to problems. 1 2 3 4 5

11. Displayed initiative to solve problems. 1 2 3 4 5

12. Met established project schedules. 1 2 3 4 5

13. Was responsive to contract changes. 1 2 3 4 5

14. Provided adequate project supervision. 1 2 3 4 5

15. Paid subcontractors/suppliers in a timely manner. 1 2 3 4 5

16. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

1 2 3 4 5

17. Cooperated with Government personnel after award. 1 2 3 4 5

18. How would you rate the contractor's overall performance? 1 2 3 4 5

19. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

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

“remarks.”

21. Is the contractor rated in CPARS?

ATTACHMENT 6

CONTRACTOR’S NAME: ____________________ CONTRACT NUMBER______________

Remarks:______________________________________________________________________