Attch 3 - Laundry Services - FA6670-23-R-0004 - Past Performance Questionnaire.pdf

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

The 914th Contracting Flight at the Niagara Falls Air Refueling Station is in the process of competitively selecting a source for Laundry Services.

One of the considerations in proposal evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your written response no later than 14 July 2023. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations, if necessary.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to andrew.church@us.af.mil. Please call Andrew Church at 716-236-2216 if you have any questions. Your completed questionnaire will become a part of the official source selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

Mary E. Pyle Platts Contracting Officer

1 Atch Laundry Services - FA6670-23-R-0004 - Past Performance Questionnaire

FA6670-23-R-0004

Laundry Cleaning Svc FA6670-23-R-0004

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: ____________________ Telephone Number: ____________________ Address: __________________________ Fax Number: _________________________

__________________________ Point of Contact: ______________________

(The government enters the following information based on list of references provided by the offeror.

The offeror will enter this information if the solicitation requires him to submit questionnaires to the references.)

Project Title and Brief Description of Work: _____________________________________*

Contract Number Provided by Offeror: ___________________ Dollar Amount: ________*

Contract Period or Dates of Performance Provided by Offeror: ______________________* Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ____________________________

Address: _____________________ Telephone Number: ___________________ _____________________________ Fax Number: _____________________ _____________________________ Email Address: _____________________

C. EMAIL COMPLETED SURVEY FORM TO: andrew.church@us.af.mil

FA6670-23-R-0004

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

E G S M U N

Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

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 were satisfactory.

Performance does not meet some contractual requirements.

The contractual performance of the element or sub-element 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 of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Performance was not observed or not applicable to the current effort being reported against.

CONTRACTOR’S NAME: ________________________

CONTRACT NUMBER: __________________________

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix above.

The contractor: E G S M U N

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

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The contractor: E G S M U N

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

6. Provided effective quality control and/or inspection procedures to meet contract requirements.

7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

8. Provided timely resolution of contract discrepancies.

9. Identified problems as they occurred.

10. Suggested alternative approaches to problems.

11. Displayed initiative to solve problems.

12. Met established delivery schedules.

13. Was responsive to contract changes.

14. Provided adequate project supervision.

15. Paid subcontractors/suppliers in a timely manner.

16. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

17. Cooperated with Government personnel after award.

18. How would you rate the contractor's overall performance?

19. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.” YES/NO

20. Would you award another contract to this contractor? If not, explain in “remarks.”

YES/NO

CONTRACTOR’S NAME: ________________________

CONTRACT NUMBER: __________________________

Remarks:______________________________________________________________________

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