B.08 Attachment 1 PPQ.docx

Past Performance Questionnaire The Regional Health Contracting Office-Atlantic (Gordon Health Contracting Branch) is conducting a competitive acquisition.

Solicitation Number W91YTZ-21-R-0062, is for the Bulk Laundry and Linen Services at Winn Army Community Hospital, Fort Stewart, Georgia.

Please complete the following questionnaire to assist our evaluation of the contractor’s past performance, and return via email no later than 9 September 2021, 4 PM EST to kiah.m.washington.civ@mail.mil and brett.a.daniels.civ@mail.mil Regional Health Contracting Office-Atlantic Gordon Health Contracting Branch, Fort Gordon, GA 30905

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does (and/or) notify the Contracting Specialist/ Officer. Please return the completed Questionnaire to the Point of Contact identified below within the stated timeframe.

Rating Definitions:

Acceptable: Performance meets contractual requirements.

Unacceptable: Performance does not meet contractual requirements.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Acceptable

· Unacceptable

B. Effectiveness of Project Management (to include use and control of subcontractors).

C. Timeliness of Performance for Services and Product Deliverables.

D. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· unacceptable

E. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to kiah.m.washington.civ@mail.mil & brett.a.daniels.civ@mail.mil

Thank you for your assistance.