Atch_6._Past_Performance_Questionnaire.pdf

ATTACHMENT 6 (FA2550-15-R-2000)

Full Food Service Schriever AFB, CO

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Information IAW FAR 2.101 and 3.104

This attachment will not be incorporated into the resultant contract

A. GENERAL INFORMATION: Please complete the following information on the contractor that provided or is currently providing services or a product for your company.

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 3 years, please complete separate evaluation forms for those contracts as well.

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

B. RESPONDENT INFORMATION:

Name of Respondent: ________________________________ Title:

Address: ______________________________ Telephone Number: _________________________

_____________________________________ Fax Number: ___________________________

_____________________________________ Email Address: ___________________________

Date you completed this questionnaire: _______________________________________

C. EMAIL COMPLETED SURVEY FORM TO:

Debra L. Santos, 50 CONS/LGCB, E-MAIL to debra.santos@us.af.mil

D. Evaluation

Indicate the contractor’s past performance for each category area below by identifying with an “√” for the most appropriate rating according to the scale shown below. Provide rationale, including specific examples, as appropriate, to support your ratings in the space provided for comments for each category area. If more space is needed, continue your comments in the “Additional Comments” section at the end of this questionnaire. It is important that the information be as factual, accurate, and complete as possible to preclude the need for follow-up by the evaluators. If there is an area that you do not have detailed knowledge then you may consult with someone in your organization that does.

Consider the criteria for each category area in Table 1 in the assessment.

TABLE 1- PERFORMANCE RATINGS

Rating Description

Exceptional Performance meets contractual requirements and exceeds many to the Government's benefit.

The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective

Very Good Performance meets contractual requirements and exceeds some to the Government's benefit.

The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor's corrective actions appear or were ineffective

Not Rated Not applicable or has no history.

1. How well did the contractor supply the service that conformed to the performance work statement:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Rated

Please explain Exceptional, Marginal or Unsatisfactory rating:

2. How well did the contractor ensure that the proper numbers of employees were there when needed:

3. How well did the contractor complete all tasks in a timely manner:

4. How effectively did the contractor implement corrective actions for marginal or unsatisfactory performance:

5. How well did the contractor respond to exercise and real world situations with a sense of urgency:

6. How well was the contractor proactive when given customer comments:

7. How well did the contractor show initiative in improving service throughout the period:

8. The overall performance on this contract is:

9. How well did the contractor comply with base HAZMAT requirements:

Additional Comments:

Thank you for your time in filling out the questionnaire.

The completed survey is to ONLY be viewed by the government. Do not submit a copy of the completed questionnaire to anyone other than Debra L. Santos, Contract Specialist via email: debra.santos@us.af.mil.

When filled in this document is Source Selection Information IAW FAR 2.101 and 3.104