ATTACHMENT L4 PAST PERFORMANCE QUESTIONNAIRE.docx

Controlled Unclassified Information When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Section L FA248623RA001 Attachment L4: Past Performance Questionnaire Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? ☐ Yes ☐ No

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / e-mail address:

D. Respondent’s position (e.g., Program Manager, PCO/ACO, etc.):

E. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

F. Other suggested points of contact:

Section 4: Performance Information

In the tables below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – 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.

V VERY GOOD – 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.

S SATISFACTORY – 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.

M MARGINAL – 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.

U UNSATISFACTORY – 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.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

Background:

The requirements of our AGE contract include: Provide personnel, equipment, tools, materials, vehicles, supervision, logistics, training, technical support, and other items and services (except those items and services specifically identified as Government furnished) necessary to manage and perform the services of this contract. The service provider shall provide AGE maintenance, support tasks and functions specified within the Performance-based Work Statement (PWS) for the 96th Test Wing. The service provider is encouraged and expected to generate innovative approaches to efficiently and effectively accomplish tasks, functions, and requirements within this PWS in a quality manner and in a way which fosters pride and ownership in the work performed. The service provider shall ensure work, services, and operations are in compliance with local, state, and federal laws and regulations, publications, and applicable technical orders (TOs). Additionally, the service provider shall comply with safety, security, and environmental requirements. Sections in TOs, AF, Major Command (MAJCOM) or local regulations that refer to Bioenvironmental Engineering for Occupational Health support and evaluation shall be accomplished by the service provider's industrial hygiene/occupational health specialist except where specifically spelled out in the contract.

A. Phase-In/Transition Plan In evaluating the Contractor’s management approach, consider the following items:

- Ability to accomplish all phase-in/transition plans with all phase-in/transition activities completed within the required time limit.

- Ability to provide a detailed plan on employees’ proof of qualifications/certifications.

- Ability to provide a detailed plan on new employee hiring, retention of current personnel, training/orientation, badging activities and any security clearance issues prior to contract start.

- Ability to provide a detailed plan to have all vehicles in place and serviceable to include the service providers logo on each vehicle at contract start.

a. The Contractor’s phase-in/transition plans with phase-in/transition activities was:

b. The Contractor’s ability to provide employees’ proof of Qualifications and or certifications was:

c. The Contractor’s ability on new employee hiring, retention of current personnel, training/orientation, badging activities and any security clearance issues prior to contract start was:

d. The Contractor’s Ability to have all vehicles in place and serviceable to include the service providers logo on each vehicle at contract start was:

B. Program Management In evaluating the Contractor’s approach to program management, consider the following items:

a. The Contractor’s ability to provide an organizational structure to include reporting chain for daily operations and mission events; an organization chart identifying key personnel positions.

b. The Contractor’s ability to provide a key personnel listing by position and section clearly identifying those responsible for the respective flight commander/flight chief and non-commissioned officer in charge (NCOIC) duties outlined in each applicable section IAW AFI 21-101 as per the PWS.

c. The Contractor’s ability to provide listing of all contractor proposed vehicles by type and number.

d. If subcontracting, the Contractor’s ability to describe their approach for subcontracting and managing any subcontracted efforts. Include a description of the functions that will be performed by subcontractors and where the performance will take place.

e. The Contractor’s ability to provide a training approach that addresses all contractor (and subcontractor if applicable) employees, and ensures the workforce is technically qualified to meet the PWS requirements on an initial and continuing basis.

f. The Contractor’s ability to provide a “draft” of the plans/programs as requested prior to contract start such as:

a. The Contractor’s organizational structure to include reporting chain for daily operations and mission events; an organization chart identifying key personnel positions was:

b. The Contractor’s key personnel listing by position and section clearly identifying those responsible for the respective flight commander/flight chief and non- commissioned officer in charge (NCOIC) duties outlined in each applicable section IAW AFI 21-101 as per the PWS was:

c. The Contractor’s listing of all contractor proposed vehicles by type and number was:

d. If subcontracting, the Contractor’s approach for subcontracting and managing any subcontracted efforts. Include a description of the functions that will be performed by subcontractors and where the performance will take place was:

e. The Contractor’s training approach that addresses all contractor (and subcontractor if applicable) employees, and ensures the workforce is technically qualified to meet the PWS requirements on an initial and continuing basis was:

f. The Contractor providing a “draft” of the plans/programs as requested prior to contract start was:

C. Management of Personnel In evaluating the Contractor’s approach to management of personnel, consider the following items:

a. The Contractor’s ability to provide a staffing approach in numbers with a matrix showing proposed manning by shift and number of personnel per shift for each shop for day to day operations; an approach for obtaining additional workforce as needed to support contingency plans.

b. The Contractor’s ability to maintain home station operations during times of TDY/deployments.

c. The Contractor’s ability to monitor, track and provide all Personal Protective Equipment to employees.

a. The Contractor’s ability to provide a staffing approach in numbers with a matrix showing proposed manning by shift and number of personnel per shift for each shop for day to day operations; an approach for obtaining additional workforce as needed to support contingency plans was:

b. The Contractor’s ability to maintain home station operations during times of TDY/deployments:

c. Contractor’s ability to monitoring, tracking and providing all Personal Protective Equipment to employees was:

D. Quality Control In evaluating the Contractor’s approach Quality Control, consider the following items:

a. The ability to provide QC inspectors for every shift during normal duty hours.

b. The ability to effectively conduct root cause analysis for corrective actions on findings by QC and/or the Government and how the proposed fix ensured no repeat occurrences.

c. The ability to provide a plan on implementing and sustaining the Self-inspection/MICT program.

a. The Contractor’s ability to provide an organizational chart for the QC office to include the responsibilities per inspector was:

b. The Contractor’s ability to effectively conduct root cause analysis for corrective actions on findings by QC and/or the Government and how the proposed fix ensured no repeat occurrences:

c. The ability to provide a plan on implementing and sustaining the Self- inspection/MICT program was:

How accurately did the contractor forecast contract costs?

How well did the contractor meet forecasted costs and perform within contract costs?

How successfully did the contractor alert the Government of unforeseen costs before they occurred?

How sufficient and timely was the contractor’s cost reporting?

Government Contracts Only: Was this contract partially or completely terminated for default or convenience, or are there any pending terminations?

☐ Yes ☐ Default ☐ Convenience ☐ Pending Terminations ☐ No

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules).

SECTION 5: GENERAL COMMENT

Given what I know today about the contractor’s ability to execute what they promised in their proposal, I [ click and select an item ] award to them today given that I had a choice.

REMARKS:

Please provide any additional comments concerning this contractor’s performance, as desired.

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please email this completed questionnaire to:

ronald.wilson.22@us.af.mil

RONALD J.WILSON

Contracting Officer

AFTC/PZZ

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