Attachment 5 - Past Performance Questionnaire.pdf

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Attached to
DeCA Custodial Services
Solicitation number
FA557022Q0003
Issued by

About this file

This document contains a past performance questionnaire template and details of a federal contract solicitation for custodial services. The solicitation is seeking custodial services at three Royal Air Force bases in the United Kingdom in support of Defense Commissary Agency facilities. Services required include general cleaning, restroom maintenance, floor care, waste removal and other custodial tasks detailed in attached performance work statements. Responses are due by the date specified in the solicitation issued by the United States Air Forces in Europe and Africa on behalf of the Department of the Air Force. The incumbent contractor or key personnel are to be evaluated using the past performance questionnaire, which addresses factors such as managerial experience, on-time performance, quality control and problem-solving abilities.

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FA557022Q0003 Attachment 5

Past and Present Performance Questionnaire

A. GENERAL INFORMATION:

Vendor’s Name: Telephone Number:

Address: Fax Number:

Point of Contact:

Project Title and Brief Description of Work:

Contract Name/Number: $/£ Amount:

Contract Period or Project Period of Performance:

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

B. RESPONDENT INFORMATION:

Name of Respondent: Title:

Company/Organization:

Address: Telephone Number:

Fax Number:

Email Address:

C. EMAIL COMPLETED SURVEY FORM TO: lawrence.roman.gb@us.af.mil and graham.staudt@us.af.mil

D. PERFORMANCE INFORMATION:

Satisfactory Unsatisfactory

Performance meets contractual requirements. The contractual performance of the element or sub-element may have contained some minor problems for which corrective actions taken by the vendor were satisfactory.

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

mailto:lawrence.roman.gb@us.af.mil mailto:heaven.carroll@us.af.mil

Select the appropriate column using the definitions matrix above.

The contractor: Satisfactory Unsatisfactory

Not

Applicable

1. Vendor provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements and provide adequate project supervision at the place of performance.

2. Vendor performed services on time.

3. Vendor’s quality control process were followed and were effective.

4. Vendor displayed initiative to solve problems or correct deficiencies and follow-up to ensure desired results were achieved.

5. How would you rate the vendor's overall performance?

REMARKS/COMMENTS:

Vendors Name:
Telephone Number:
Address:
Fax Number:
undefined:
Point of Contact:
Project Title and Brief Description of Work 1:
Project Title and Brief Description of Work 2:
Contract NameNumber:
Amount:
Contract Period or Project Period of Performance:
Vendor performed as the: Off
Prime Contractor: Off
SubContractor: Off
Name of Respondent:
Title:
CompanyOrganization 1:
CompanyOrganization 2:
Address 1:
Address 2:
Telephone Number_2:
Fax Number_2:
Email Address:
Check Box1: Off
Check Box2: Off
Check Box3: Off
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box7: Off
Check Box8: Off
Check Box9: Off
Check Box10: Off
Check Box11: Off
Check Box12: Off
Check Box13: Off
Check Box14: Off
Check Box15: Off
Text16:

File details come from the government source that posted it. Updated .