Attachment L-02 - Past Performance Questionnaire.pdf
PDF 98 KB Posted
- Attached to
- Repair Well #10 Federal contract opportunity
- Solicitation number
- FA301025R0026
About this file
This is a Past Performance Questionnaire for solicitation FA301025R0026 issued by the 81st Contracting Squadron at Keesler Air Force Base, Mississippi. The questionnaire is being used to evaluate contractor past performance for a project involving repairs to Well #10 Casing, Drop Pipe, Pump, Instrumentation, and Controls at Building B7301 on Keesler AFB.
The completed questionnaire must be submitted directly to A1C Ty Le at ty.le@us.af.mil no later than 11:00 AM CST on September 8, 2025, from a corporate or government email account. The form requires detailed information about the referenced contract including contract number, value, period of performance, and contact information for both the evaluator and the offeror. The evaluation covers five key performance areas: Quality (ability to meet work requirements), Schedule (timeliness of deliverables and problem resolution), Management (ability to manage all work aspects), Regulatory Compliance (meeting safety and labor standards like Davis-Bacon Act), and an Overall Rating. Each category uses a six-point scale ranging from Exceptional to Unsatisfactory, with a Not Applicable option, and includes space for detailed comments explaining the ratings.
View the file
Other files for this federal contract opportunity
Show all 13
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
PAST PERFORMANCE QUESTIONNAIRE
Solicitation No. FA301025R0026
Please complete this questionnaire and email to: ty.le@us.af.mil
We are currently preparing our proposal for the 81st Contracting Squadron, Keesler AFB, MS, Solicitation Number: FA301025R0026 for repairing the Well #10 Casing, Drop Pipe, Pump, Instrumentation, and Controls at B7301 on Keesler AFB, MS. As part of our proposal, we have listed you as a reference on our performance for this type of service with your agency or company under the previous or ongoing contract listed below. Your input on our performance is therefore requested.
This Questionnaire is due to A1C Ty Le no later than 11:00 AM CST on September 8, 2025. The Questionnaire must be submitted directly to the Contracting Officer from a corporate or government email account.
If you will be unavailable on September 8, 2025, for verification (if necessary) of this past performance evaluation, please indicate another point of contact (POC) for the Contracting Officer to contact.
Thank you.
POC/Alternate POC Name:
POC/Alternate POC Phone Number:
POC/Alternate POC Email Address:
Name of Offeror:
Phone Number:
Email Address:
CONTRACT REFERENCED
Contract Number (including Task Order number if applicable):
Contract Value (including all modifications):
Period of Performance:
Name of Person Completing Questionnaire:
Agency/Company:
Title:
Phone:
Email:
Brief Description of Work Required in the Referenced Contract:
EVALUATION
Please rate the contractor utilizing the guide below. Explanatory narratives giving specific details would be appreciated. Attach additional pages if more space is needed. Evaluation Definitions:
The following definitions should be used in assessing Contractor performance.
Exceptional: Performance EXCEEDS MANY contractual requirements. Performance being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
Very Good: Performance EXCEEDS SOME contractual requirements. Performance being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Satisfactory: Performance MEETS contractual requirements. Performance being evaluated contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.
Marginal: Performance MEETS SOME contractual requirements. Performance reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginal effective or were not fully implemented.
Unsatisfactory: Performance DOES NOT MEET contractual requirements. Performance contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
Not Applicable (N/A): Performance information is not recent or relevant as defined in the solicitation. Unable to provide assessment.
PAST PERFORMANCE EVALUATION
QUALITY
What is your assessment of the Contractor’s ability to meet work requirements and the overall quality of the work?
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Quality of Work
Comments:
SCHEDULE
What is your assessment of the Contractor’s ability to provide end-products timely?
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Timeliness Ability to Resolve Timeliness Problems
MANAGEMENT
What is your assessment of the Contractor’s ability to manage all aspects of the work?
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Managing Work Aspects
REGULATORY COMPLIANCE
What is your assessment of the Contractor’s ability to meet all regulatory requirements? Examples would include safety regulations, Davis-Bacon Act and other labor standards.
Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Complying with Regulations
OVERALL RATING OF CONTRACTOR’S PERFORMANCE
What is your overall rating of the Contractor’s performance on the contract being assessed.
Exceptional Very Good Satisfactory Marginal Unsatisfactory
General Comments:
| We are currently preparing our proposal for the 81st Contracting Squadron Keesler AFB MS Solicitation: |
| POCAlternate POC Name: |
| POCAlternate POC Phone Number: |
| POCAlternate POC Email Address: |
| Name of Offeror: |
| Phone Number: |
| Email Address: |
| Contract Number including Task Order number if applicable: |
| fill_10: |
| Period of Performance: |
| Name of Person Completing Questionnaire: |
| AgencyCompany: |
| Title: |
| Phone: |
| Email: |
| Brief Description of Work Required in the Referenced Contract: |
| Exceptional: |
| Very Good: |
| Satisfactory: |
| Marginal: |
| Unsatisfactory: |
| Not Applicable NA: |
| ExceptionalQuality of Work: |
| Very GoodQuality of Work: |
| SatisfactoryQuality of Work: |
| MarginalQuality of Work: |
| UnsatisfactoryQuality of Work: |
| NAQuality of Work: |
| CommentsRow1: |
| ExceptionalTimeliness: |
| Very GoodTimeliness: |
| SatisfactoryTimeliness: |
| MarginalTimeliness: |
| UnsatisfactoryTimeliness: |
| NATimeliness: |
| ExceptionalAbility to Resolve Timeliness Problems: |
| Very GoodAbility to Resolve Timeliness Problems: |
| SatisfactoryAbility to Resolve Timeliness Problems: |
| MarginalAbility to Resolve Timeliness Problems: |
| UnsatisfactoryAbility to Resolve Timeliness Problems: |
| NAAbility to Resolve Timeliness Problems: |
| CommentsRow1_2: |
| ExceptionalManaging Work Aspects: |
| Very GoodManaging Work Aspects: |
| SatisfactoryManaging Work Aspects: |
| MarginalManaging Work Aspects: |
| UnsatisfactoryManaging Work Aspects: |
| NAManaging Work Aspects: |
| CommentsRow1_3: |
| ExceptionalComplying with Regulations: |
| Very GoodComplying with Regulations: |
| SatisfactoryComplying with Regulations: |
| MarginalComplying with Regulations: |
| UnsatisfactoryComplying with Regulations: |
| NAComplying with Regulations: |
| CommentsRow1_4: |
| ExceptionalRow1: |
| Very GoodRow1: |
| SatisfactoryRow1: |
| MarginalRow1: |
| UnsatisfactoryRow1: |
| General CommentsRow1: |
| undefined: |
File details come from the government source that posted it. Updated .