Attachment 3 - PPQ - FA441721R0017.pdf

For Official Use Only When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Past Performance Questionnaire

FA441721R0017

The 1st Special Operations Contracting Squadron at Hurlburt Field, FL is competitively selecting a source for Base Supply Services.

One of the considerations in the evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your written response no later than 05 Oct 2021 at 11:00 CST. This schedule will allow sufficient time to analyze the data.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to lacey.shalenko@us.af.mil and charles.carnley@us.af.mil. Please confirm receipt of this questionnaire. For questions, please contact Lacey Shalenko at (850) 884-7691 or Cecile Bodison at (850) 884-7692. Your completed questionnaire will become a part of the official source selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

CHARLES M. CARNLEY

CONTRACTING OFFICER

Past Performance Questionnaire

FA441721R0004

Attachment 4

Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Program Description:

G. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

H. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

I. Description of work performed:

J. Was this a competitively awarded contract? ☐ Yes ☐ No

K. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

Past Performance Questionnaire

FA441721R0004

Attachment 4

Note: If offeror holds or has held other contracts for Base Supply Services with your agency/organization in the last three (3) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone/fax number/e-mail address:

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

E. Other suggested points of contact:

Section 4: Performance Information

In the table below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Past Performance Questionnaire

FA441721R0004

Attachment 4

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

The Contractor: E V S M U N/A

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

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

4. Provided a sufficient number of qualified personnel to meet contract requirements.

SUPPORTING INFORMATION:

5. Met or exceeded contractual workloads and expectations.

SUPPORTING INFORMATION:

6. Met or exceeded timelines for submitting reports and deliverables.

Past Performance Questionnaire

FA441721R0004

Attachment 4

The Contractor: E V S M U N/A

SUPPORTING INFORMATION

7. Complied with security requirements.

SUPPORTING INFORMATION

8. Followed approved quality control plan.

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

11. Identified problems as they occurred.

SUPPORTING INFORMATION:

12. Suggested alternative approaches to problems.

SUPPORTING INFORMATION:

13. Displayed initiative to solve problems.

SUPPORTING INFORMATION:

14. Was responsive to contract changes.

SUPPORTING INFORMATION:

15. Provided adequate project supervision.

SUPPORTING INFORMATION:

16. Paid subcontractors/suppliers in a timely manner.

Past Performance Questionnaire

FA441721R00017

Attachment 4

The Contractor: E V S M U N/A

SUPPORTING INFORMATION:

17. Cooperated with Government personnel after award.

SUPPORTING INFORMATION:

18. How would you rate the contractor's overall performance on this contract?

SUPPORTING INFORMATION:

19. Was the contractor ever issued a letter of concern, cure notice, or show cause notice under the referenced contract? If yes, explain.

EXPLANATION:

☐ Yes

☐ No

20. Would you award another contract to this contractor? Please explain.

EXPLANATION:

☐ Yes

☐ No

21. Is the contractor rated in CPARS?

EXPLANATION:

☐ Yes

☐ No

22. Did the Contractor establish realistic progress schedules?

EXPLANATION:

☐ Yes

☐ No

23. Did the Contractor meet or exceed the established project schedules?

EXPLANATION: ☐ Yes

☐ No

24. Did the Contractor communicate any and all issues/concerns to the appropriate personnel?

EXPLANATION:

☐ Yes

☐ No

25. Has the contractor provided Base Supply Services for any of these functions: Quality Assurance, Inventory, Document Control, HAZMART, CRF, or Delivery? If yes, which ones?

EXPLANATION:

☐ Yes

☐ No

Past Performance Questionnaire

FA441721R0004

Attachment 4

Additional remarks:

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

E-mail to: lacey.shalenko@us.af.mil and charles.carnley@us.af.mil