Attch 3 - Past Performance Questionnaire.docx

Source Selection Information -- See FAR 2.101 and 3.104 – FOR OFFICIAL USE ONLY Base Telecommunication System Service

Attachment 2 Past and Present Performance Questionnaire

The 87th Contracting Squadron is in the process of competitively selecting a contractor to perform Base Telecommunication System Services at Joint Base McGuire Dix Lakehurst, New Jersey 08641.

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 [insert number of days].

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to richard.driscoll.2@us.af.mil. Your completed questionnaire will become a part of the official Source Selection records. Please keep in mind that questionnaires must be sent by the organization completing the questionnaire. No questionnaires will be accepted by the potential offeror.

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.

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

Contractor’s Name: Address:

Telephone Number:

Fax Number:

Point of Contact:

Project Title or Brief Description of Work : ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Contract Number Provided by Offeror: Dollar Amount:

Contract Period or Dates of Performance Provided by Offeror:

*Note: If offeror holds or has held other contracts with your agency/organization in the last 5 years, please complete separate evaluation forms for those contracts as well.

Contractor performed as the: Prime Contractor Sub-Contractor Key Personnel.

B. RESPONDENT INFORMATION:

C. EMAIL COMPLETED SURVEY FORM TO: richard.driscoll.2@us.af.mil.

D. PERFORMANCE INFORMATION: Choose the number on the scale of 0 to 5 that most accurately describes the contractor’s performance or situation. Indicate Not Applicable (N/A) as necessary.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS.

CONTRACTOR’S NAME: ___________________ CONTRACT NUMBER __________

The contractor:

Remarks:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________