Attachment 5 - Past and Present Performance Questionnaire due 3SEP21.pdf

FA527021Q0030

Attachment 5

Past and Present Performance Questionnaire

PAST AND PRESENT PERFORMANCE

QUESTIONNAIRE

FOR

SOLICITATION NO. FA527021Q0030

Hood and Duct Cleaning Services, Kadena AB, Okinawa, Japan

Past and Present Performance Questionnaire

PAST PERFORMANCE QUESTIONAIRE

FOR

SOLICITATION NO. FA527021Q0030

The government is placing increased emphasis in its acquisitions on “past performance” as a source selection evaluation factor. You have been provided as a reference in response to the subject solicitation for Hood and Duct Cleaning Services, Kadena AB, Okinawa, Japan. In order for the government to evaluate the past performance of the firm providing you as a reference please provide frank, concise comments regarding your assessment of the contractor’s performance regarding this project. In accordance with FAR 15.306(e)(4), the name of individuals providing reference information about an offeror’s past performance shall not be disclosed.

Upon completion of this survey, please send it by e-mail to the address shown below no later than

3 SEP 2021 10:00AM (Japan Standard Time).

18th

Contracting Squadron/PKA Attn:

Marina Amosin Phone: 098-938-1111 Ext/DSN: 634-7619 Bldg. 99, Kadena AB, Okinawa

E-mail address: marina_joyce.amosin.ph@us.af.mil

The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable.

In the event of inconsistency between English language and translation thereof into Japanese language, the English language meaning shall control.

If you have any questions concerning this survey, please call Marina Amosin at 634-7619 (DSN) 098-938-1111 then DSN as the extension (Commercial) or send e-mail.

Your time and effort in providing this vitally important information are greatly appreciated.

mailto:maasa.migita.2.jp@us.af.mil

Past and Present Performance Questionnaire

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor:

B. Cage Code of contractor contract was awarded to:

C. Contract number:

D. Contract type:

E. Was this a competitive contract? Yes No

F. Period of performance:

G. Initial contract cost: $

H. Current/final contract cost: $

I. Reasons for differences between initial contract cost and final contract costs:

J. Description of service provided:

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name:

B. Evaluator's title:

Past and Present Performance Questionnaire

C. Evaluator's phone/fax number:

Number of years evaluator worked on subject contract:

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

E EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VG VERY GOOD- The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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 meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N NOT APPLICABLE - Unable to provide a score.

Past and Present Performance Questionnaire

Technical Performance E VG S M U N

T1 Quality & repeatability of operations

T2 Ability to properly ensure and maintain an athesticly pleasing ground

T3 Adequacy/effectiveness of environmental safety procedures

T4 Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements

Program Management E VG S M U N

P1. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)

P2. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes)

P3. Timeliness/effectiveness of contract problem resolution without extensive customer guidance

P4. Understand/complied with customer objectives and technical requirements

P5. Successfully responded to emergency and/or surge situations

P6. Quality/effectiveness of sub-contracted efforts

P7. Effectiveness of material management (including Government Furnished Property or Material)

P8. Effectiveness of acquisition management

P9. Contractor proposed alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the customer

P10. Contractor implemented responsive/flexible processes to improve quality and timeliness of support.

Transition/phase-in E VG S M U N

T1. Contractor ability to smoothly transition resources and personnel.

T2. Contractor effectiveness on maintaining continuity of mission support while transitioning/phasing in resources and personnel to support other efforts.

Past and Present Performance Questionnaire

Employee Retention/Attraction E VG S M U N

E1. Ability to hire/apply a qualified workforce to this effort.

E2. Ability to retain a qualified workforce on this effort.

E3. Effectiveness of employee compensation towards quality of work.

Fiscal Responsibility Performance E VG S M U N

C1 Accuracy in forecasting requirements monetary value

C2 Ability to meet forecasted monetary requirements and perform within contract constraints

C3 Ability to alert Government of unforeseen fiscal anomalies before they occur

C4 Sufficiency and timeliness of reporting

2. Please discuss each and every response for which you indicated as marginal or unsatisfactory in response to the questions above (use additional sheets, if necessary).

3. Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

Yes Default Convenience ＿＿ Pending Terminations

No

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

Past and Present Performance Questionnaire

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs? Has election ever been made not to exercise a contract option or continue relations due to the contractor’s poor performance?

Overall Assessment E VG S M U N

What is your overall assessment of this past performance for this contractor?

Would you hire this contractor again? If not, explain.

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address: marina_joyce.amosin.ph@us.af.mil