Attachment 4 - Past Performance Questionnaire.pdf

Attachment 4

FA561321R0001

For Official Use Only

PAST PERFORMANCE QUESTIONNAIRE

This acquisition is for Fitness Instruction, Massage Therapy, and Sports Officiating for the Kaiserslautern Military Community.

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: Address:

Telephone Number:

Email Address:

Point of Contact:

Project Title or Brief Description of Work*:

Contract Number*: Contract Amount:

Contract Period or Dates of Performance*:

Approximate Number of Passengers per Year:

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

To be completed by the respondent and returned directly to the contracting office.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RATER INFORMATION:

Name of Rater: Name of Rater:

Title: Title:

Address: OR Address:

Phone Number: Phone Number:

Email Address: Email Address:

C. RETURN COMPLETED SURVEY NOT LATER THAN 28 DEC 2020 TO:

Diane Feguer/Contract Specialist

700 CONS/PKA

diane.feguer@us.af.mil +49-631-536-6418 or DSN 489-6418 and

Douglas Lindsey/Contracting Officer

700 CONS/PKA

douglas.lindsey@us.af.mil +49-631-536- 5284 or DSN 489-5284 mailto:erika.voss_elsaesser.1.de@us.af.mil mailto:caterina.rothhaar.de@us.af.mil

CONTRACTOR’S NAME: CONTRACT NUMBER:

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

E G S M U N Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets contractual requirements and exceeds many to your organization’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements and exceeds some to your organization’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements.

The contractual performance of the element or sub-element being assessed contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Performance does 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.

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

Performance was not observed or not applicable to the current effort being reported against.

Place an “X” in the appropriate column using the definitions matrix above.

The contractor… E G S M U N

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

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

3. …provided sufficient manning at all times to perform the required services.

4. …corrected deficiencies in timely manner and pursuant to their quality control procedures .

5. ……identified problems as they occurred.

6. …provided timely resolution of contract discrepancies.

7. …suggested alternative approaches to problems.

8. …complied with environmental requirements, if applicable.

9. …displayed initiative to solve problems.

10. …provided timely resolution of defects.

11. …was responsive to contract changes.

12. ...performed fitness instruction in a class environment.

13. …performed physical training.

14. …performed massage therapy.

15. …performed sports official duties

16. ...prepared to perform duties with necessary contractor supplies, if applicable.

17. …provided properly trained/certified personnel.

18. …provided adequate substitute personnel to perform duties in place of intially scheduled trainer, therapist, sports official.

19. …used government/other than contractor provided equipment/materials responsibly.

General: E G S M U N

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

23. Would you award another contract to this contractor? If not, explain in “remarks.” YES / NO For US Government contracts only: E G S M U N

24. The contractor followed Government accepted Quality Control Plan.

25. The contractor cooperated with Government personnel after award.

26. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.” YES / NO

27. Is the contractor rated in CPARS? YES / NO

Remarks: