Attachment 4 - Past Performance Questionaire.pdf

Attachment 4

Past Performance Questionnaire – Solicitation FA558723Q0049

The 48th Contracting Squadron, RAF Lakenheath, United Kingdom needs continued Total Containment Bullet

Trap (TCT-4) Repair and Service for the small arms firing range at RAF Feltwell.

One of the considerations in proposal 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 below questionnaire. In order to meet the acquisition milestones, we request your written response no later than 08 September 2023.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to aylin.basoluk-jackson.gb@us.af.mil, and courtney.chiporo@us.af.mil. Your completed questionnaire will become a part of the official evaluation.

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

Questionnaire

Section 1: Contract Identification

A. Vendor Name:

B. Address:

C. Telephone Number:

D. Point of Contact:

E. Contractor Cage Code:

F. Contract Name/Number:

G. Contact Amount:

H. Program Title:

I. Project Title and Brief Description of Work:

J. Period of Performance:

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

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel mailto:aylin.basoluk-jackson.gb@us.af.mil mailto:courtney.chiporo@us.af.mil

Note: If offeror holds or has held other contracts 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: EMAIL COMPLETED SURVEY FORM TO:

aylin.basoluk-jackson.gb@us.af.mil courtney.chiporo@us.af.mil

Section 5: 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.

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.

mailto:aylin.basoluk-jackson.gb@us.af.mil mailto:courtney.chiporo@us.af.mil

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. 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 processes were followed and were effective.

4. Vendor displayed initiative to solve problems or correct deficiencies and follow-up to ensure desired results were achieved in timely manner and pursuant to their quality control procedures.

5. Vendor met established project schedules.

6. Vendor was responsive to contract changes.

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

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

EXPLANATION:

☐ Yes

☐ No

Additional remarks:

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

aylin.basoluk-jackson.gb@us.af.mil courtney.chiporo@us.af.mil mailto:aylin.basoluk-jackson.gb@us.af.mil mailto:courtney.chiporo@us.af.mil