Attachment 17 - Past Performance Questionnaire.pdf

23 CONS/Services Flight Source Selection Sensitive Information IAW FAR 2.101 and FAR 3.104

RFQ: FA483024Q0001

Title: CATM Range Maintenance Moody AFB, GA

Past and Present Performance Questionnaire October 2023

SUBJECT: Request for Past Performance Evaluation

TO: ________________________________________

You have been identified as a point of contact for a past and/or present performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for a Combat Arms Training and Maintenance (CATM) Range Maintenance Service contract at Moody AFB, GA.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, I can be contacted at

Please submit completed questionnaire to the Government Contract Specialist and Contracting Officer identified on the attached questionnaire.

Contractor Signature

1 Attachment:

Past and Present Performance Questionnaire

RFQ: FA483024Q0001

Title: CATM Range Maintenance Moody AFB, GA

I. GENERAL INFORMATION:

To Be Completed by the Contractor

A. Offeror Information:

Name (Company/Division):

CAGE Code: UEI Number:

If Other than the Prime Offeror, Identify Prime Offeror:

B. Program Title:

C. Contract Specifics:

Contracting Agency or Customer:

Contract Number:

Contract Type:

______ Firm Fixed Price (FFP) Contract ______ FFP Task Order or Purchase Order, ______ Cost Reimbursable or Other Contractual Arrangement Period of Performance (include options):

Contract Dollar Value:

Has the contract been entered into the Contractor Performance Assessment Reporting System (CPARS)?

Yes or No

Contract Environment:

_______ Performance on an Air Force or Air Reserve Base _______ Performance on a DoD Installation _______ Performance at a Federal, State, County or City facility _______ Other Performance Location

D. Description of Contract as ___________ Prime or __________ Subcontractor Indicate the type of services provided and highlight portions considered most relevant to the CATM Range Maintenance acquisition.

RFQ: FA483024Q0001

Title: CATM Range Maintenance Moody AFB, GA

II. RESPONDENT INFORMATION:

To Be Completed by the Respondent

A. Contact Information Name of Respondent: _____________________ Title: _________________________________________ Address: ______________________________________________________________________________ Telephone Number: _____________________________________________________________________ Fax Number: ___________________________________________________________________________ Email Address: _________________________________________________________________________

B. Is the information provided by the Contractor in Section I, General Information accurate? ______ Yes ______ No If not explain which information is not accurate (use separate page if needed):

C. SEND COMPLETED SURVEY FORM TO EMAIL ADDRESSES BELOW:

Contracting Officer:

Contract Specialist:

Ms. Kalyn Runey SrA Christian Lau Wong kalyn.runey@us.af.mil christian.lau_wong@us.af.mil mailto:mary.twitty.1@us.af.mil mailto:erica.johnson.18@us.af.mil mailto:kalyn.runey@us.af.mil

RFQ: FA483024Q0001

Title: CATM Range Maintenance Moody AFB, GA

III. PERFORMANCE INFORMATION:

To Be Completed by the Respondent

Choose the appropriate letter on the scale (E, G, S, M, U, N) that most accurately describes the Contractor’s performance or situation or N/A if performance in this area is not applicable to the effort addressed.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

E G S M U N

Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets contractual requirements and exceeded many to the Government’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the Contractor were highly effective.

Performance meets contractual requirements and exceeded some to the Government’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the Contractor were effective.

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the Contractor were satisfactory.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element 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.

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

Performance was not observed or not applicable to the current effort being reported against.

RFQ: FA483024Q0001

Title: CATM Range Maintenance Moody AFB, GA

CONTRACTOR’S NAME: ____________________CONTRACT #: _______________

Place an “X” in the appropriate column using the definitions matrix above.

Contractor Performance or Situation E G S M U N N/A

1. How well did the Contractor implement an orderly transition from the incumbent Contractor?

2. How well did the Contractor comply with contractual terms and conditions including the preparation and timely/accurate submission of any required documents?

3. How well did the Contractor perform basic maintenance and repair services, preventative maintenance, and inspections on small arms training range bullet traps ?

4. How well did the Contractor manage personnel clearances in order to regularly service secured locations?

5. How well does the Contractor’s organization provide the necessary manning, training, equipment, and supplies to meet contractual requirements?

6. How would you rate the Contractor’s skills/expertise, knowledge, and qualifications?

7. Rate Contractor’s ability/flexibility to respond to workload fluctuations, e.g. budgetary fluctuations that resulted in increased or decreased activities.

8. How willing was the Contractor to improve and correct noncompliance issues or concerns?

9. How well did the Contractor comply with all Federal, State, EPA, OSHA and local regulatory requirements?

10. How well did the Contractor handle, remove, document, and properly dispose of hazardous /non-hazardous wastes?

11. How well did the Contractor meet any special performance requirements, if applicable? If the Contractor did not perform any special requirements, rate as N/A.

12. How would you rate the overall performance of the Contractor under this contract?

13. Was the Contractor ever issued a default, cure or show cause notice, Notice of Violation under the referenced contract? If yes, explain outcome in “remarks.”

YES/NO

14. Would you award another contract to this Contractor? If not, explain in “remarks.” YES/NO

15. If a Government Contract, is the Contractor rated in CPARS? YES/NO

RFQ: FA483024Q0001

Title: CATM Range Maintenance Moody AFB, GA

Remarks (provide detail regarding unfavorable ratings):