Past performance Questionaire.doc

AiT Steel Toe Boots

RFQ#F3V5A21145A001

PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire and email: elias.johnson-saucier@sheppard.af.mil or send by facsimile [FAX 940-676-2178] to:

Elias A Johnson-Saucier, A1C, USAF Contract Specialist

Required Response Date: 04Nov11

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options): $

6. TYPE OF CONTRACT:

7. DESCRIPTION OF CONTRACT REQUIREMENTS:

Please add a continuation page if additional space necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION: a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please circle the response code for each topic (A – G) that best reflects your experience with this contractor.

O = Outstanding

E = Excellent A = Adequate

M = Marginal P = Poor

N/O = Not Observed

A. Quality of Products and Services - Assess the contractor’s conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards).

O E A M P N/O

B. Performance – Assess the contractor’s performance as the primary contractor for the supply of boots.

A M P

C. Schedule – Assess the timeliness of contractor against the schedule of activities.

A M P

D. Technical Requirements – Assess the contractor’s ability to fulfill the technical requirements of the contract.

A M P

E. Warranty – Assess the contractor’s adherence to the warranty and timeliness of substitution.

A M P

F. Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.

A M P

G. Overall Assessment.

A M P