Attachment 5- Pope C130 Move - Past Performance Questionnaire.pdf

Attachment 5

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:

Seymour Johnson AFB is in the process of evaluating offers from companies capable of providing:

All labor, equipment, tools, materials, transportation, supervision, and other items and services necessary to safely move, park, tie-down, and upgrade a decommissioned C-130E model trainer to convert it into a stationary trainer for 352 Special Warfare Training School curriculum at Pope Army Airfield, North Carolina.

In order for the 4th Contracting Squadron to conduct its evaluation, we request that you complete the questionnaire below and e-mail a PDF file to paula.miller.5@us.af.mil and michael.demers.4@us.af.mil. The due date for completed questionnaires is July 15, 2020 at 2:00 p.m. EST. Your completed questionnaire will become a part of the official source selection record. 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, include request for conformation with submission.

mailto:usarmy.detrick.medcom-nrmc.mbx.hcaa-nrmc@mail.mil

C. CONTRACT INFORMATION: Please complete.

Contract Name and/or Number

Task Order number:

Type of Contract:

Performance Period: (Base plus any options):

Performance Period for the task order:

Annual Contract Values:

Total Contract Dollar Value: (base plus any options)

Number of FTEs / Session-based:

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

(1) Contractor demonstrated ability to plan for and provide knowledgeable employees.

(2) The Contractor adhered to the period of performance in accordance with the contract.

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

Instructions: