Attachment 5 - Past Performance Questionnaire.docx

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

Section L Attachment: Past Performance Questionnaire (PPQ) The 36th Contracting Squadron is in the process of competitively selecting a source for a project to repair Installation Command Post Radio and Antenna System. This project includes but is not limited to the installation of four (4) government furnished contractor installed (GFCI) antennas with spare for future antennas and associated mounting brackets on the roof which includes the installation of conduits running from the antennas to Radio Room 131. This project will also include installation of conduits and associated fittings from Room 131 to Room 123, Room 143, and Room 110 with the installation of GFCI cables, pull boxes, cable trays, associated hardware, associated grounding, and bonding, required testing, firestopping, associated drilling and concrete scanning, and restoration of affected areas. Room 123 requires a minimum of 12 cables, Room 143 requires minimum of 6 cables, and Room 110 requires minimum of 2 cables. Facility will be designed as permanent construction in accordance with Department of Defense Unified Facilities Criteria 1-200-01. This project will comply with Department of Defense antiterrorism/force protection requirements per Unified Facilities Criteria 4-010-01.

One of the considerations in proposal evaluation is the verification of the offerors’ 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 those contracts or work efforts.

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 07 September 2023.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and emailed to chuck_david.flore@us.af.mil and tara.sablan@us.af.mil. Your completed questionnaire will become a part of the official Source Selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

Tara B. Sablan Contracting Officer

Attachement (1) - Past Performance Questionnaire (PPQ)

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 Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. 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):

J. Description of work performed:

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

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

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: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / fax number / e-mail address:

D. Respondent’s position (e.g., Program Manager, PCO/ACO, etc.):

E. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

F. Other suggested points of contact:

Section 4: Performance Information

In the tables 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 contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

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

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

How well did the contractor meet the technical requirements of the project?

COMMENTS:

How well did the contractor adhere to the schedule?

How well did the contractor integrate and coordinate activities to execute the project?

Government Contracts Only: Was this contract 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).

SECTION 5: GENERAL COMMENT

Given what I know today about the contractor’s ability to execute what they promised in their proposal, I [ click and select an item ] award to them today given that I had a choice.

REMARKS:

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return to: chuck_david.flores@us.af.mil / tara.sablan@us.af.mil Controlled Unclassified Information Page 4 of 4