Attachment 7 Past Performance Questionnaire.pdf

FOR OFFICIAL USE ONLY

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104

UESTIONNAIRE

Page 1 FOR OFFICIAL USE ONLY SOURCE SELECTION SENSITIVE – SEE FAR 3.104

PAST PERFORMANCE QUESTIONNAIRE

FA300222R0001

ATTACHMET 7

25 August 2021

SECTION A: CONTRACTOR INFORMATION

1. Contractor’s Name and Address:

2. Point of Contact:

3. Phone Number:

5. Period of Performance:

SECTION B: RESPONDENT INFORMATION

1. Respondent’s Organization

Name & Address:

2. Respondent’s Name:

3. Phone Number: Fax Number:

E-Mail:

7. Period of Performance:

Start Date: End Date:

4. Contract Number: Contract Type:

Final Amount: 4. Award Amount:

5. Project Title:

6. Scope of Work:

Training Location(s):

UESTIONNAIRE

Page 2 FOR OFFICIAL USE ONLY SOURCE SELECTION SENSITIVE – SEE FAR 3.104

PAST PERFORMANCE QUESTIONNAIRE

FA300222R0001

ATTACHMENT 7

25 August 2021

SECTION C: Government Points of Contact:

Contract Specialist: Mr. Joseph Ocampo

Email: joseph.ocampo.3@us.af.mil

Contracting Officer: Mr. A. Ryan Rodriguez

Email: arnold.rodriguez.3@us.af.mil

SECTION D: PERFORMANCE INFORMATION: Choose letter on the scale that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY

UNSATISFACTORY OR MARGINAL RATINGS.

E V S M U N

Exceptional

(Outstanding)

Very Good

(Above Average)

Satisfactory Marginal Unsatisfactory Not Applicable

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.

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.

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.

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.

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.

Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available.

1. QUALITY:

☐ Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory ☐Not

Applicable mailto:joseph.ocampo.3@us.af.mil mailto:arnold.rodriguez.3@us.af.mil

UESTIONNAIRE

Page 3 FOR OFFICIAL USE ONLY SOURCE SELECTION SENSITIVE – SEE FAR 3.104

COMMENTS/REMARKS:

2. SCHEDULE:

☐ Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory ☐Not

Applicable

3. COST CONTROL:

☐ Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory ☐Not

Applicable

4. MANAGEMENT:

☐ Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory ☐Not

Applicable

COMMENTS/REMARKS:

UESTIONNAIRE

Page 4 FOR OFFICIAL USE ONLY SOURCE SELECTION SENSITIVE – SEE FAR 3.104

COMMENTS/REMARKS:

5. SMALL BUSINESS SUBCONTRACTING:

☐ Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory ☐Not

Applicable

6. REGULATORY

☐ Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory ☐Not

Applicable

OVERALL PERFORMANCE RATING:

☐ Exceptional ☐Very Good ☐Satisfactory ☐Marginal ☐Unsatisfactory ☐Not

Applicable

COMMENTS/REMARKS:

Respondent Signature: ______________________________________________