Attachment 4 - Past Performance Questionnaire.pdf

Controlled Unclassified Information (CUI) When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Controlled Unclassified Information (CUI) Page 1 of 3

RFQ FA500023Q0039

Attachment 4 Past Performance Questionnaire

SUBJECT: Request for Past Performance Evaluation

TO:

is currently participating as a respondent to the Government’s Request for solicitation No. FA500023Q0039 for Vertical Transportation Equipment Maintenance services at Joint Base Elmendorf-Richardson, Alaska.

The Government will be selecting Contractors for this project based on selection factors. One of the key factors in the Government’s final decision is past performance. To assist the Government in its assessment of Contractor past performance, we are required to identify previous projects and clients who are familiar with our past work. For the purposes of this questionnaire, past work is defined as contracts performed and/or being performed for any customer within the last five (5) years from the issuance day of the solicitation (28 April 2023).

As one of our customers for past contracting work on , we are requesting that you complete the attached questionnaire regarding our past performance. This letter also authorizes you to discuss our past performance with the Government and to release information regarding our past performance to the Government.

Your prompt attention in completing the attached questionnaire will ensure we receive full consideration in this competition. Please return the completed form to the Government point of contacts (POCs) identified below. Response is required no later than 2:00 P.M. Alaska Daylight Time (AKDT) on Tuesday, 19 May 2023.

Government POCs Chase Manning – chase.manning@us.af.mil Sheng Morris – sheng.morris@us.af.mil

Thank you for your assistance.

(Signature and title of individual with the authority to sign for and legally bind the Contractor) mailto:chase.manning@us.af.mil mailto:sheng.morris@us.af.mil

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RFQ FA500023Q0039

Attachment 4 Past Performance Questionnaire

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. Brief Description of Services Performed:

1. Please select what type of VTE were maintained and repaired under this contract?

(Select all that apply) ☐ Chairlift ☐ Freight ☐ Passenger ☐ Freight & Passenger

2. Please select the ages of VTE maintained under this contract? (Select all that apply) ☐ >75 Years old ☐ >65 Years old ☐ >55 Years old ☐ >45 Years old ☐ >35 Years old ☐ >25Years old ☐ <25Years old

G. Period of Performance:

H. Contract Dollar Value:

I. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor

Section 2 : Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of work performed (i.e., local, nationwide, worldwide, other Command):

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:

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RFQ FA500023Q0039

Attachment 4 Past Performance Questionnaire

Section 4 : Performance Information

Scope of Work Yes No

1. Does your contract involve maintenance and repairing an average of 45 or more VTE annually?

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. The performance rating scale is defined as follows:

RATING DEFINITION

O Outstanding Contractor performance is meeting (or did meet) all contract requirements and is exceeding (or did exceed) some, if not all contract requirements. For any problems encountered, corrective action taken by the contractor were highly effective.

S Satisfactory During the contract period, contractor performance is meeting (or did meet) contract requirements. For any problems encountered, corrective action taken by the contractor were effective.

U Unacceptable During the contract period, contractor performance is not meeting (or did not meet) contract requirements. For any problems encountered, corrective action appeared only marginally, not effective, or not fully implemented. Customer involvement was required.

N/A Not Applicable Used if the rating(s) are not going to be applied to a particular area for evaluation.

Contractor Performance: O S U N/A

1. How would you rate the Contractor’s ability to maintain standards outlined in your Performance Work Statement, Statement of Work, or equivalent requirements documents?

2. How would you rate the Contractor’s ability to provide managers and supervisors with the technical and administrative abilities needed to meet contract requirements?

3. How would you rate the Contractor’s ability to perform maintenance and repairs in a timely manner?

4. How would you rate the Contractor’s ability to correct deficiencies pursuant to their quality control procedures?

5. How would you rate the Contractor’s ability to respond to routine and emergency service calls?

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Chase Manning – chase.manning@us.af.mil and Sheng Morris – sheng.morris@us.af.mil mailto:chase.manning@us.af.mil mailto:sheng.morris@us.af.mil