Attachment 5 - PPIF.docx
DOCX document 20 KB Posted
- Attached to
- Base Telecommunication Services (BTS) - Minot AFB, ND Federal contract opportunity
- Solicitation number
- FA4528-24-Q-KM03
About this file
This document is a past performance information form to be completed by a customer reference and submitted in response to solicitation number FA4528-24-Q-KM03, issued by the 5th Contracting Squadron of the Department of the Air Force Global Strike Command. The solicitation is for base telecommunication services at Minot Air Force Base in North Dakota. The form requests information on the contractor's performance on a previous contract, including their ability to hire and replace qualified personnel, the evaluator's rating of past performance, whether they would award another contract to the contractor, and whether any cure notices or terminations were issued. The completed form must be returned no later than the offer due date to James Sulhoff at the provided address, phone number, or email.
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Text version
PAST PERFORMANCE INFORMATION FORM
The 5th Contracting Squadron, Minot AFB, North Dakota, is in the process of selecting a contractor for base Telecommunications Services (BTS). One of the considerations in proposal evaluation is the verification of the Offeror’s past and present performance on contracts, which reflect the Offeror's ability to perform on the proposed effort. We depend on information received from agencies such as yours, which have had first-hand experience with an Offeror, for the evaluation of the Offeror's performance on those contracts.
Please complete this form and provide comments wherever applicable. Please sign the document in the space provided. Please note, we may contact the Offeror on problem areas or concerns identified to see what corrective actions have been taken or will be taken. However, the individual's name completing the questionnaire will not be disclosed to the Offeror.
Please return the completed form as soon as possible but no later than the offer due date noted in the Solicitation. Please obtain this date from your BTS contractor. The completed document should be marked Source Selection Sensitive. Forms submitted directly from the Contractor being evaluated will be thrown out.
Respondent and Contract Information:
Name of Customer/Contract:
Address:
Name and Title of Evaluator:
Signature of Evaluator and Date:
Telephone No:
Dates/Years of Performance:
Annual $ Value:
Contract Number:
Contractor Name & Address:
Contractor performed as the Prime Contractor Sub-Contractor
Services Performed/Detailed Description of Work:
Did the contractor demonstrate the ability to hire, maintain, and replace, if necessary, qualified personnel?
FA4528-
-Q- K M0 Attachment
Page of
How would you rate the contractor’s past performance?
Would you award another contract to this contractor? If not, please explain:
Was the contractor ever issued a cure or show cause notice, or was the contract terminated? If yes, please explain:
Is the contract rated in CPARS? Yes No
Remarks:
SEND COMPLETED SURVEY FORM TO:
5 CONS/PKAS, 165 Missile Ave., Minot AFB, ND 58705 ATTN: James Sulhoff
FAX: (701) 723-4172
EMAIL: james.sulhoff@us.af.mil
DUTY PHONE: (701) 723-3086
File details come from the government source that posted it. Updated .