Attachment 3- Past Performance Questionnaire blank.pdf

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Attached to
Airfield Sunshade Fabric Replacement Federal contract opportunity
Solicitation number
W50S6S20R0004
Issued by
Department of the Army Arizona Army National Guard

About this file

This solicitation seeks proposals for the replacement of airfield sunshade fabric at an Arizona Army National Guard facility. The requirement is set aside 100% for small businesses with a NAICS code of 332311 and size standard of 750 employees. Interested vendors may request a site visit by June 8th and must submit any questions by June 11th. Proposals are due by the date specified in beta.sam.gov and must be sent to the listed email address, including a completed SF1449. The federal agency involved is the Department of the Army Arizona Army National Guard.

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Other files for this federal contract opportunity

Other files attached to Airfield Sunshade Fabric Replacement, newest first.
File Type Posted
SF30 W50S6S20R0004 - Amendment 0003.docx DOCX document
Reference Photos.pptx PPTX presentation
Amended Q AND A - W50S6S20R0004.docx DOCX document
SF30 - W50S6S20R0004 - Amendment 0002.docx DOCX document
(Amended) Attachment 1 - Statement of Need .docx DOCX document
Q AND A - W50S6S20R0004.docx DOCX document
SF30 - Amendment 0001 - W50S6S20R0004.docx DOCX document
Attachment 1 - Statement of Need.docx DOCX document
SF1449 - W50S6S20R0004.docx DOCX document
Attachment 2 - Reference_List Blank.doc DOC document

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Text version

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

SECTION A: Contractor Information

A. Contractor’s name and address: __ _________________________________________

B. Point of Contact: _____________________________

C. Phone Number (with area code): _________ __________

D. Contract number: ________________________________________

E. Project Title or Description of Work performed under this project: ___ _______________________________

F. ContractType:
Firm‐Fixed‐PriceIndefinite‐Delivery/IndefiniteQuantityTaskOrderCost‐Reimbursement

G. Contract Award Date: Scheduled Completion Date: _____________________________

H. Contract Award Amount: Current/Final Project Amount: ____________________

I. Contractorbeingevaluatedperformedasthe:
PrimeContractorSubcontractorSupplieronthiscontract/order.

SECTION B: RESPONDENT INFORMATION

EVALUATED BY:

(Signature) (Date)

_________________________________ Organization:____________________________________
(TypedorPrintedName)

______________________ Address: _______________________________ (Title)

(EmailAddress)
PhoneNumber:_______________________________

NOTE: The identity of individual(s) providing the reference information shall not be disclosed.

Source Selection Sensitive

PERFORMANCERATINGQUESTIONNAIRE
(Contractortoforwardtotheirreferencesforcompletion)
(ThisQuestionnaire,whencompleted,shallbetreatedasSourceSelectionSensitiveinaccordance
withFAR3.104‐3andshallnotbedisclosedtoanyoneoutsidetheGovernment)
TheRATINGdefinitionsareasfollows:
EEXCEPTIONAL–Performancemet/meetscontractualrequirementsandexceeded/exceedmany
requirementstotheorganization’sbenefit.Nocontractualperformanceproblemsfortheelementbeing
assessedhaveoccurredorifanyminorproblemsoccurredthecorrectiveactionstakenbythecontractor
werehighlyeffective.
VVERYGOOD–Performancemet/meetscontractualrequirementsandexceeded/exceedssome
requirementstotheorganization’sbenefit.Thecontractualperformanceoftheelementbeingassessedwas
accomplishedwithsomeminorproblemsforwhichcorrectiveactionstakenbythecontractorwereeffective.
SSATISFACTORY–Performancemet/meetscontractualrequirements.Thecontractualperformanceof
theelementbeingassessedwasaccomplishedwithsomeminorproblemsforwhichcorrectiveactionstaken
bythecontractorweresatisfactory.
MMARGINAL–Performancedidnot/doesnotmeetsomecontractualrequirements.Thecontractual
performanceoftheelementbeingassessedreflectsaseriousproblemforwhichthecontractorhasnotyet
identifiedcorrectiveactions,orthecontractor’sproposedactionsappearonlymarginallyeffective,orwere
notfullyimplemented.
UUNSATISFACTORY–Performancedidnot/doesnotmeetmostcontractualrequirementsandrecovery
isnotlikelyinatimelymanner.Thecontractualperformanceoftheelementbeingassessedcontainsserious
problem(s)forwhichthecontractor’scorrectiveactionswereineffectiveorwerenotimplementedtimely.

N NOT APPLICABLE – Unable to provide a score. Performance in this area not applicable.

PERFORMANCERATINGQUESTIONNAIRE
(Contractortoforwardtotheirreferencesforcompletion)
(ThisQuestionnaire,whencompleted,shallbetreatedasSourceSelectionSensitiveinaccordance
withFAR3.104‐3andshallnotbedisclosedtoanyoneoutsidetheGovernment)

The contractor:

1 How efficient was the contractor in abiding by all Rules, Regulations, Laws, and Safety Standards?

2 Were you satisfied with the quality of service performed or items supplied?

3 How effective were the contractor’s quality control and/or inspection procedures?

4 How well did the contractor perform in a respect to timeliness and schedule?

5 How well did the contractor resolve Issues/

Problems/Customer Complaints?

6 How flexible, cooperative, reasonable was the contractor, particularly when faced with short‐notice mission changes or requirements changes?

7 How well was the contractorabletomaintaina
good relationship withagencycontractingand
technical/projectmanagementpersonnel?

8 How likely are you to award another contract to this contractor?

9 Wasthecontractoreverissuedacure or show cause
noticeunderthereferencedcontract?Ifyesexplain
outcomein‘remarks’ sectionbelow.

ADDITIONAL REMARKS:

**Please forward this questionnaire directly to the 162D Wing Contracting Office **

E‐MAIL: usaf.az.162-wg.list.msg-msc@mail.mil Subject: W50S6S-20-R-0004 PPQ

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Check Box25: Off
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Check Box1: Off
Check Box2: Off
Check Box3: Off
Check Box4: Off
Check Box5: Off
Text7:
Dropdown1: [Very Good]
Dropdown3: [Satisfactory]
Dropdown4: [Marginal]
Dropdown5: [Marginal]
Dropdown6: [Not Applicable]
Dropdown7: [Very Good]
Dropdown8: [Marginal]
Dropdown9: [Not At All Likely]
Dropdown10: [No]

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