Attachment 4 -Past Performance Questionnaire.pdf

PAST AND PRESENT PERFORMAANCE QUESTIONNAIRE

SUBJECT: Request for Past Performance Evaluation

TO:_______________________________________________

The 354th Contracting Squadron at Eielson AFB, AK is in the process of competitively selecting a contractor for Cadavers and Perfusion Training at Eielson AFB.

One of the considerations in the evaluation is the verification of the offeror’s 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 the contracts or work efforts.

Offerors shall complete Section 1, Contract Identification and send the Past Performance Questionnaires to their contract POCs listed in their Past Performance Volume.

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 10:00 AM AST on 3 January 2025. This schedule will allow us 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 kai.croghan@us.af.mil and ryan.baudoin@us.af.mil.

Your prompt attention to this questionnaire is greatly appreciated. For questions, please contact A1C Kai Croghan or SSgt Ryan Baudouin.

mailto:kai.croghan@us.af.mil mailto:ryan.baudoin@us.af.mil

Section1: 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:

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. Total # of Subject Matter Experts contracted at your location:

K. Was the contract for Cadavers and Perfusion Training?

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

M. Contractor’s Role: ☐ Prime Contractor ☐ Sub Contractor ☐ Key Personnel

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 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/met contractual requirements with many exceeded to the respondent’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

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

G Good – Performance meets/ met contractual requirements with some exceeded to the respondent’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

S Satisfactory – Performance meets/met contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

M Marginal – Performance does not/did not meet some contractual requirements.

The contractual performance of the element or sub-element 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/did not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A Not Applicable – Performance was not observed or not applicable to the current effort being reported against.

The contractor: E G S M U N

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

2. Provided adequate project supervision.

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

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

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

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

8. Identified problems as they occurred.

9. Suggested alternative approaches to problems.

10. Displayed initiative to solve problems.

11. Met established project schedules.

12. Was responsive to contract changes.

13. Complied with all federal, state, and local laws and regulations to include licensing.

14. Complied with all DoD regulations (if applicable).

The contractor: E G S M U N

15. How would you rate the contractor's overall performance?

16. Did this project have any manning issues? If so, explain in the “remarks”.

YES / NO

17. Did this project include work on a military installation?

YES / NO

18. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES / NO

19. Would you award another contract to this contractor?

If not, explain in “remarks”.

YES / NO

20. Is the contractor rated in CPARS (if applicable for Government contracts)?

YES / NO

Additional Remarks:

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

E-Mail to: kai.croghan@us.af.mil and ryan.baudoin@us.af.mil.

For Official Use Only

When filled in, this document is Source Selection Sensitive Information IAW FAR 2.101 and 3.104 mailto:kai.croghan@us.af.mil mailto:ryan.baudoin@us.af.mil