B08 - 0012 - Past Performance Questionnaire.pdf
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- Solicitation number
- W519TC-25-R-0005
About this file
This file is a Past Performance Questionnaire template from the U.S. Army Contracting Command - Rock Island (ACC-RI) for RFP W519TC-25-R-0005, which evaluates contractor performance on previous relevant contracts. The questionnaire must be completed and returned to the Contracting Officer within 15 days of receipt or by March 25, 2025.
The questionnaire consists of three parts: contract identification information to be completed by the offeror, performance evaluation ratings to be completed by the point of contact, and return instructions. The evaluation section rates contractors on a four-level scale (Substantial Confidence, Satisfactory Confidence, Limited Confidence, No Confidence) across four performance areas: compliance with requirements/workmanship, project management effectiveness, timeliness of performance, and customer satisfaction. Each rating requires a written rationale, and the form includes sections for general comments, other reference sources, and respondent identification. The completed questionnaire must be returned to Contracting Officer Alex Sheppard or Contract Specialist Chelsey Love at their provided Army email addresses.
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Text version
Past Performance Questionnaire – Cover Letter
DEPARTMENT OF THE ARMY
U.S. ARMY CONTRACTING COMMAND – ROCK ISLAND
January 10, 2025
SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal
(RFP) W519TC-25-R-0005
Dear Sir/Ma’am, The US Army Contracting Command – Rock Island (ACC-RI) is currently conducting a competitive source selection to evaluate offerors on the subject RFP. As part of this evaluation, we have requested that the offerors provide information about their past performance on recent and relevant federal, state, or local government or commercial contracts as compared to the North American Industry Classification System [NAICS] 322219. You have been identified as the point of contact cited on the enclosure.
Your assessment of their performance is extremely valuable to our evaluation.
Please complete the enclosure and return to the Army Contracting Command- Rock Island (ACC-RI), Rock Island, Illinois 61299, no later than 15 days after receipt of request or 25 March 2025, whichever occurs first. Submit your completed questionnaire to:
Alex Sheppard, Contracting Officer, Alex.r.sheppard.civ@army.mil Chelsey Love, Contract Specialist, Chelsey.m.love.civ@army.mil
Your cooperation is greatly appreciated. Questions may be directed to the undersigned at Alex.r.sheppard.civ@army.mil
Sincerely, Alex Sheppard Contracting Officer mailto:Alex.r.sheppard.civ@army.mil mailto:Alex.r.sheppard.civ@army.mil
Past Performance Questionnaire
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 notify the Contracting Officer. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.
Rating Definitions:
Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.
Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.
Limited Confidence: Performance does not meet some contractual requirements.
Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective. The offeror has had little success performing the required effort.
No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.
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:
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
� Substantial Confidence � Satisfactory Confidence � Limited Confidence � No Confidence
Rationale: __________________________________________________________
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
E. General Comments. Provide any other relevant performance information.
Comments: _________________________________________________________
F. Other Information Sources. Please provide the following information:
Are you aware of other relevant past efforts by this company?
If yes, please provide the name and telephone number of a point of contact:
Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________
G. Respondent Identification. Please provide the following information:
Organization:
Name:
Title:
Date:
Telephone Number
E-mail Address:
PART III. RETURN INFORMATION
Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.
Thank you for your assistance.
| Past Performance Questionnaire: | |
| A CONTRACT IDENTIFICATION: | |
| No Confidence: | |
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| No Confidence_2: | |
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| No Confidence_3: | |
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| No Confidence_4: | |
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| E General Comments Provide any other relevant performance information: | |
| Comments 1: | |
| Comments 2: | |
| If yes please provide the name and telephone number of a point of contact: | |
| Point of Contact Name: | |
| 2025-02-21T12:36:54-0600 | |
| SHEPPARD.ALEX.RYAN.1535773463 |
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