Attachment 4 - Past Performance Questionnaire.docx

Offeror’s Company Name

PAST PERFORMANCE QUESTIONNAIRE

Past Performance Questionnaire: Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does. Please return the completed Questionnaire within 3 days and return this completed Questionnaire and send via e-mail to the following addresses: derrick.cash.4@us.af.mil

Offerors not complying with the terms of the solicitation or failing to submit a complete proposal package may be found non-responsive, and not considered for award.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type: Firm Fixed Price Prime Contractor Name (if different from the contractor name cited above): __________ Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased: ____________________________ Value of Contract: $

B. IDENTIFICATION OF OFFEROR REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship.

Exceeds Contractual Requirements (Explanation must be provided in Comments field below) Meets Contractual Requirements Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below) Comments:

B. Timeliness of Performance for Services and Product Deliverables, including the Administrative Aspects of Performance.

Exceeds Contractual Requirements (Explanation must be provided in Comments field below) Meets Contractual Requirements Failed to Meet Contractual Requirements (Explanation must be provided in Comments field below) Comments:

C. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest.

Exceptional (Explanation must be provided in Comments field below) Satisfactory Unsatisfactory (Explanation must be provided in Comments field below) Comments:

D. Overall Satisfaction.

1. Did Contractor manage the project appropriately?

2. Did Contractor meet or exceed all scheduling requirement?

3. Did Contractor adhere to its Quality Control Plan?

Extremely Satisfactory (Explanation must be provided in Comments field below) Satisfactory Unsatisfactory (Explanation must be provided in Comments field below) Comments:

E. General Comments. Provide any other relevant performance information.

F. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company? _______ If yes, please provide the name and telephone number of a point of contact:

G. Respondent Identification. Please provide the following information:

Organization: __________________________________________________ Name: _____________________________________________________________ Title: ________________________________________________ Date: _____________________________________________________________ Telephone Number: _________________________________________________ Address: _____________ Fax Number: ___________________________________________________________ E-mail Address: ________________________________________

Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this proposal.