Attachment 3 - Past Performance Questionnaire.pdf

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Attached to
FA557021Q0001 - Medical Custodial Services
Solicitation number
FA557021Q0001
Issued by

About this file

This document contains a past performance questionnaire for a federal contract opportunity to provide Medical Custodial Services at two Royal Air Force bases in the United Kingdom. The U.S. Air Force is soliciting proposals to perform custodial services in accordance with the attached performance work statement. The past performance questionnaire requests information about the vendor's previous contracts including project details, value, period of performance, and role as either prime contractor or subcontractor. It also contains questions regarding the vendor's management, timeliness, quality control, problem-solving abilities, and overall performance on past projects that should be rated as satisfactory or unsatisfactory. Proposals are due to the Department of the Air Force United States Air Forces in Europe - Air Forces Africa by the dates indicated on the solicitation number FA557021Q0001.

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FA557021Q0001 Attachment 3

Past and Present Performance Questionnaire

A. GENERAL INFORMATION:

Vendor’s Name: Telephone Number:

Address: Fax Number:

Point of Contact:

Project Title and Brief Description of Work:

Contract Name/Number: $/£ Amount:

Contract Period or Project Period of Performance:

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

B. RESPONDENT INFORMATION:

Name of Respondent: Title:

Company/Organization:

Address: Telephone Number:

Fax Number:

Email Address:

C. EMAIL COMPLETED SURVEY FORM TO: lawrence.roman.gb@us.af.mil and heaven.carroll@us.af.mil

D. PERFORMANCE INFORMATION:

Satisfactory Unsatisfactory

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

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

mailto:lawrence.roman.gb@us.af.mil mailto:heaven.carroll@us.af.mil

Select the appropriate column using the definitions matrix above.

The contractor: Satisfactory Unsatisfactory

Not

Applicable

1. Vendor provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements and provide adequate project supervision at the place of performance.

2. Vendor performed services on time.

3. Vendor’s quality control process were followed and were effective.

4. Vendor displayed initiative to solve problems or correct deficiencies and follow-up to ensure desired results were achieved.

5. How would you rate the vendor's overall performance?

REMARKS/COMMENTS:

Vendors Name:
Telephone Number:
Address:
Fax Number:
undefined:
Point of Contact:
Project Title and Brief Description of Work 1:
Project Title and Brief Description of Work 2:
Contract NameNumber:
Amount:
Contract Period or Project Period of Performance:
Vendor performed as the: Off
Prime Contractor: Off
SubContractor: Off
Name of Respondent:
Title:
CompanyOrganization 1:
CompanyOrganization 2:
Address 1:
Address 2:
Telephone Number_2:
Fax Number_2:
Email Address:
Check Box1: Off
Check Box2: Off
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box7: Off
Check Box8: Off
Check Box9: Off
Check Box10: Off
Check Box11: Off
Check Box12: Off
Check Box13: Off
Check Box14: Off
Check Box15: Off
Text16:

File details come from the government source that posted it. Updated .