Attachment 4 Past Performance Questionnaire.pdf

Attachment 4

FA301023R0035

PAST PERFORMANCE QUESTIONNAIRE

A. OFFEROR’S REFERENCE INFORMATION:

Contract Name and/or Number (include task order number(s) if applicable) Company/Division Name to be evaluated

Address:

Point of Contact (POC):

Title of POC:

Telephone Number:

Email

Contractor performed as: Prime contractor Contractor performed as: Sub-Contractor Joint Venture Affiliate To/With _____________________

B. RESPONDENT INFORMATION: Please complete.

Contracting Activity/Customer

Address:

Telephone Number:

Email Address:

Point of Contact (POC):

Title of POC:

Keesler AFB is in the process of soliciting offers from companies capable of providing:

___________Multimedia Services_______________________________.

In order for the 81st Contracting Squadron to conduct its evaluation, we request that you complete the questionnaire below and e-mail a PDF file to craig.meints@us.af.mil, Contract Specialist and cynthia.lee.2@us.af.mil, Contracting Officer, at 81 CONS, Keesler AFB. The due date for completed questionnaires is 27 Sep 23 at 2:00PM CST. Your completed questionnaire will become a part of the official source selection records. To be considered, the Past Performance Questionnaire shall be returned to the Contract Specialist in its entirety and by the due date and time specified above.

To confirm receipt of your completed/submitted questionnaires please contact Contract Specialist, Craig Meints at craig.meints@us.af.mil AND Contracting Officer, Cynthia Lee at cynthia.lee.2@us.af.mil.

PAST PERFORMANCE QUESTIONNAIRE

C. CONTRACT INFORMATION: Please complete.

Contract Name and/or Number

Task Order number (if applicable):

Type of Contract:

Performance Period: (Base plus any options):

Total Contract Dollar Value: (base plus any options)

Contract Description:

Contractor performed as: Prime contractor Contractor performed as: Sub-Contractor Joint Venture Affiliate To/With _____________________

What percentage of the contract was performed by the evaluated contractor, if available: ………………...%.

Instructions:

Please provide ratings and comments regarding the Contractor’s performance in each area below using the following ratings.

RATING DEFINITION

Exceptional

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

Very Good

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

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

Marginal

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory

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 contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective

N/A Not Applicable

Exceptional Very Good

Satisfactory Marginal Unsatisfactory

N/ A

A. QUALITY OF SERVICE AND PERFORMANCE

(1) The Contractor provided quality service that adhered to contract requirements, specifications, and standards of professional conduct.

(2) The Contractor consistently responded to problems and took appropriate action to correct performance.

B. MANAGEMENT

(1) Contractor was able to resolve customer complaints quickly and effectively.

(2) Contractor demonstrated an overall effective and quality management effort.

(3) Contractor cooperated with the Government in providing flexible, proactive and effective solutions to critical contract issues.

C. TIMELINESS/ SCHEDULE OF PERFORMANCE/SERVICES

(2) The Contractor consistently demonstrated an ability to hire, maintain, and replace, if necessary, qualified personnel in accordance with contract requirements and to avoid disruption of services and/or work schedule.

D. OTHER:

(1) Would you award this firm another contract? ( ) Yes ( ) No If you answered “No” provide an explanation. ____________________________________________________

(2) Was the contract terminated for default or cause? ( ) Yes ( ) No If you answered “Yes”, provide an explanation.___________________________________________________

(3) Has the Contractor been given a cure notice, show cause notice, suspension of progress payments in the last 3 years. ( ) Yes ( ) No If you answered “Yes”, provide an explanation and how many actions and if they were resolved:

(4) ADDITIONAL COMMENTS:

RESPONDENT SIGNATURE