Attachment_5_Past_Performance_Questionnaire.docx

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NUMBER: FA2823-15-R-3001

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

Base Operations Support Flight, Installation Contracting Division, Air Force Test Center (AFTC/PZIOA), Eglin Air Force Base, Florida is conducting a source selection for the Base Telecommunications Infrastructure Services (BTIS) IDIQ. Please complete and return this questionnaire within 5 workdays. Handwritten responses are sufficient. Do not send a copy of the completed questionnaire to the contractor being assessed. You may be contacted by our office to review the results of the questionnaire. The questionnaire information will be used in the evaluation of the Past Performance Factor contained in the Instructions to Offerors of the solicitation. Completed questionnaires will become part of the official source selection records and protected in accordance with FAR 3.104 and 2.101. Please email the completed questionnaire to both of the following:

Ronald J. Wilson, Contracting Officer: ronald.wilson.22@us.af.mil

SSG Paul V. Van Cott, Contract Specialist: paul.vancott@us.af.mil

Evaluator, please complete, date and sign the following: SECTION 1: CUSTOMER OR AGENCY IDENTIFICATION Date Evaluation Completed: _____________________________________________________ Location of Contract Performance: ________________________________________________ Evaluator Name: ______________________________________________________________ Position Title and Grade: ________________________________________________________ How long have you worked directly with Contractor?: ________________________________ Address: _____________________________________________________________________ Phone Number (DSN and Commercial): ____________________________________________ Email Address:________________________________________________________________ Are you aware of another POC that might be appropriate for completion of this questionnaire?

If so, please provide any information you can. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Evaluator’s Signature Date

Attachment 5

FA2823-15-R-3001

SECTION 2: CONTRACT IDENTIFICATION

A. Contractor:

B. Cage Code:

C. Subcontractor(s):

D. Cage Code:

E. Contract number:

F. Contract type:

G. Contractor Performed as the Prime Contractor Subcontractor Key Personnel

H. Total original contract cost/value: Total current cost/value: ____________ Reason for difference: ______________________________________________________

I. Period of Performance -- From: ___________________ To: ______________________

J. Title and brief description of services provided—

K. Does this contract provide for the accomplishments of all requirements for the installation of inside and/or outside plant cabling? (If not, what does the contract provide?)

Note: If offeror holds or has held other contracts with your agency in the last 3 years, please complete separate evaluation forms for these contracts as well.

SECTION 3: EVALUATION

The following is an explanation of the evaluation codes:

PERFORMANCE LEVEL CODES

EVALUATION AREAS

For each of the following questions, place an “X” in the appropriate block using the scale provided to the right of each question which best reflects your assessment of the contractor’s performance. Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. In the event a question is not applicable to your contract, mark N. Please provide a narrative explanation for performance deemed “Exceptional”, “Marginal”, or “Unsatisfactory”. If more comment space is needed please attach additional pages.

Contractor provided experienced managers and supervisors, with the technical and administrative abilities needed to meet contract requirements.

Comments:

How well did the contractor attract and retain qualified and fully trained personnel at all levels within their organization to ensure contract compliance?

Comments:

Contractor identified problems as they occurred. Suggested approaches to problems. Displayed initiative and cooperation to solve problems. Provided adequate information and pricing for change orders and negotiated them in good faith.

Comments:

Contractor provided effective quality control, which resulted in a quality-finished product.

Comments:

Contractor hired quality subcontractors and effectively managed them.

Comments:

Contractor developed realistic progress schedules & completed the project within the established schedule.

Comments:

How well did the contractor perform timely completion of contractual requirements to include as-builts and required reports?

Comments:

Did the contractor respond to any warranty calls in a timely manner and did the contractor effectively resolve all issues/problems identified?

Comments:

Comments:

How willing was the contractor to improve and correct noncompliance issues or concerns?

Comments:

How would you rate the overall performance of the contractor under this contract?

Comments:

Were there any contract modifications submitted for equitable cost adjustment by the contractor after the initial contract start date? If so, please explain in detail.

Comments:

Given the choice, would you award a contract to this contractor again?

Comments:

Is this contract rated in CPARS? If not, please explain below.

Comments:

Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact if known in the space provided

Comments:

Government Contracts Only : Has a show cause or cure notice ever been issued, the contract been partially or completely terminated for default/cause or convenience, or are there any pending terminations or was an option not exercised due to performance? If yes, please explain why.

Comments:

NARRATIVE SUMMARY

What were the contractor’s most positive aspects in the performance of the contract?

What were the contractor’s most negative aspects in the performance of the contract?

COMMENTS

Please provide any additional comments concerning this contractor’s performance, as desired, use additional paper if needed.

The performance assessment rating will be based upon an assessment of performance risk and represents the government’s confidence in the offeror’s probability of successfully performing as proposed. Therefore, an honest assessment with regard to this Contractor’s performance is critical. Thank you very much for taking the time to complete this questionnaire.