2._Past_Perf_Survey_Attch_1.doc

ATTACHMENT 1

ARCHITECT/ENGINEER PAST PERFORMANCE QUESTIONNAIRE

"SOURCE SELECTION SENSITIVE IAW FAR 3.104 WHEN FILLED IN"

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SAMPLE CLIENT AUTHORIZATION LETTER FORMAT

[Date of Letter]

[Name and address of A/E’s Client]

Attention: [Name and Designation of Client’s Evaluator] Dear [Contact Name]:

We are currently responding to the Malmstrom Air Force Base (AFB) Request for Qualification (RFQ) Architect-Engineer (A-E) Indefinite Delivery Indefinite Quantity (IDIQ) Contract Solicitation Number F2W3D27311AW01. Malmstrom AFB is requesting that clients of entities responding to the solicitation participate in the evaluation process. We have included our project for you company/agency as a past performance reference. An Architect/Engineer Past Performance Questionnaire is enclosed. Please complete the enclosed evaluation and return the signed, completed document to:

341st CONS/LGCA

Attn: Dennis DeForest 7015 Goddard Drive, Bldg. 145

Malmstrom AFB, MT 59402

In order to maintain the source selection integrity of this process DO NOT return the Questionnaire to us. Return it to the address listed above.

The completed Questionnaire must be received by Malmstrom AFB before the proposal due 14 September 2018.

Please direct any questions to this RFQ’s Contract Specialist, Dennis DeForest at (406)731-4647 or dennis.deforest2@us.af.mil Sincerely, [Name of Signer]

[Designation of Signer]

A. GENERAL INFORMATION

A-E FIRM TO BE EVALUATED:

Firm Name: ________________________ Telephone: __________________________ Address: __________________________ Email address: ________________________ __________________________ Point of Contact: ______________________

Project Title: _____________________________________ Description of Project: __________________________________________________________

Description of A-E Firms’ Responsibilities:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Contract Number: ______________________ Dollar Amount: ______________________ Contract Period or Dates of Performance (provided by Evaluator): _______________________ The A-E Firm performed as the ( Prime Contractor ( Sub-Contractor/Consultant.

* 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.

B. EVALUATOR INFORMATION:

Evaluator’s Company or Agency

Name: __________________________ Evaluator’s Name: _____________________

Address: __________________________ Title of Evaluator: _____________________ __________________________ Telephone: __________________________

__________________________ E-mail: ______________________________

C. SEND COMPLETED SURVEY FORM TO:

341 CONS/PKA

7015 Goddard Drive, Bldg. 145

Malmstrom AFB, MT 59402

ATTN: Dennis DeForest EMAIL: dennis.deforest.2@us.af.mil

PHONE: (406) 731-4647

D. PERFORMANCE INFORMATION: Choose the appropriate rating that most accurately describes the A/E’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF Marginal or Unsatisfactory on page 5 under Narrative Summary.

-Performance exceeded contractual requirements, to the Client’s benefit.

-Any minor problems for which corrective action taken by the A/E was highly effective.

-The A-E exceeded the expectations of the Client.

-Performance met contractual requirements with some exceeded, to the Client’s benefit.

-There were no more than some minor problems for which corrective action taken by the A/E was effective.

-The A-E met and sometimes exceeded expectations of the Client.

-Performance met contractual requirements, to the Client’s benefit.

-There were minor problems for which corrective action taken by the A/E was satisfactory.

-A-E met the expectations of the Client.

-Performance did not meet some contractual requirements.

-There were serious problems for which the A/E has not yet identified corrective actions or the A-E’s proposed actions appear only marginally effective or were not fully implemented.

-A-E did not always meet the expectations of the Client.

-Performance did not meet most contractual requirements and recovery is not likely in a timely manner.

-There were serious problem(s) for which the A/E’s corrective action(s) appear or were ineffective.

-A-E did not meet the expectations of the Client.

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

A-E FIRM’S NAME: _______________ PROJECT NAME: _______________

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 on page 4.

NO

CONTRACTOR’S NAME: ___________________ PROJECT NAME __________

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.

NARRATIVE SUMMARY (Use this section to explain any rating from the previous page)