PAST_PERFORMANCE_QUESTIONNAIRE_Attachment_4.docx

DOCX document 23 KB Posted Jun 15, 2015

Attached to: Contractor Operated Civil Engineer Supply Store (COCESS)
Solicitation number: FA282315R4007
Issued by: Department of the Air Force Materiel Command Lifecycle Management Center Robins Air Force Base

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Attachment 4 Past Performance Questionnaire

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Other files

File	Type	Posted
COCESS_Q A_13_July_2015.pdf	PDF	Jul 13, 2015
FA2823-15-R-4007_Amend_2.pdf	PDF	Jul 13, 2015
COCESS_Q A.pdf	PDF	Jul 9, 2015
FA2823-15-R-4007_Amend_1.pdf	PDF	Jul 9, 2015
COCESS_Q A.docx	DOCX document	Jun 22, 2015
COCESS_SOW_Attachment_1.pdf	PDF	Jun 15, 2015
PAST_PERFORMANCE_REFERENCES_Attachment_3.docx	DOCX document	Jun 15, 2015
COCESS_1449_Solicitation.pdf	PDF	Jun 15, 2015
COCESS_Pricing_Model_with_Market_Basket_Attachment_2.xls	XLS spreadsheet	Jun 15, 2015
Subcontract_letter_checklist_Attachment_5.pdf	PDF	Jun 15, 2015
DRAFT_COCESS_SOW_14_Apr_15.docx	DOCX document	May 6, 2015

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ATTACHMENT 4

PAST PERFORMANCE QUESTIONNAIRE

Request for Proposal: FA2823-15-R-4007 COCESS, Eglin AFB, FL 32542

1. Name of Contractor:

Contract or Identifying Number:

Title/Description of Contract:

2. Brief description of scope of work:

EXAMPLE: Provide all personnel, equipment, tools, materials, vehicles, supervision, and other items and services necessary to perform Contractor Operated Civil Engineer Supply Store (COCESS) operations.

3. Annual Awarded Amount: $____________________

EVALUATION: Please rate the Contractor utilizing the Assessment Table below. Explanatory narratives for as many responses as possible would be appreciated. These narratives need not be lengthy, just detailed. Attach additional pages if more space is needed.

ASSESSMENT TABLE

Assessment	Definition
	Substantial Confidence (SC)
	Based on the offeror’s recent/relevant performance record, we have a high expectation that the offeror would successfully perform a similar effort in the same manner.

Satisfactory Confidence

(SAT)

Based on the offeror’s recent/relevant performance record, we have a reasonable expectation that the offeror will successfully perform a similar effort in the same manner..

Limited Confidence

(LC)

Based on the offeror’s recent/relevant performance record, we have a low expectation that the offeror will successfully perform a similar effort in the same manner.

No Confidence

(NC)

Based on the offeror’s recent/relevant performance record, we have no expectation that the offeror will successfully perform a similar effort in the same manner.

Unknown Confidence (Neutral) (UC)

No recent/relevant performance record is available or the offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

1. Did the contractor have any non-conformance issues? If so, what kind?

Assessment_Rating:______________________Brief_Comment:_________________________________________________________________________________________________________________________________________________________________________________________________________________

1. Did the contractor have adequate resources to complete the required performance?

1. Did the contractor submit required documents on time and answer questions in a timely manner?

1. Did the contractor provide material to the Government at a fair and reasonable price in accordance with contract performance requirements? If no, please explain.

1. Did the contractor meet the Government’s material purchase order required delivery dates in accordance with contract performance requirements? If no, please explain.

1. Did the contractor provide current and accurate tracking/status of all material purchased in accordance with contract performance requirements? If no, please explain.

1. Did the contractor provide timely and accurate material sales invoicing/billing in accordance with contract performance requirements? If no, please explain.

1. Did the contractor set up/maintain an adequate store stock inventory of high use items and maintain adequate store stock levels for immediate material purchase in accordance with contract performance requirements? If no, please explain.

1. Did the contractor order, receive, store, issue, inventory and/or deliver hazardous material in accordance with contract performance requirements? If no, please explain.

1. Did the contractor properly identify/purchase hazardous material and provide safety data information in accordance with contract requirements? If no, please explain.

1. Did the contractor provide quality logistics support to receive, warehouse, issue, inventory and/or deliver material in timely and safe manner in accordance with contract performance requirements? If no, please explain.

1. Did the contractor furnish all required deliverables on or ahead of schedule in accordance with contract performance requirements? If no, please explain.

1. Did the contractor demonstrate a history of reasonable and cooperative behavior? If no, please explain.

1. Did the contractor’s management provide responsive problem identification and corrective problem resolution actions? If no, please explain.

1. Was the contractor cooperative and effective in correcting identified deficiencies? If no, please explain.

1. Did contractor provide quality customer service? If no, please explain.

1. Did the contractor provide experienced managers/supervisors with technical and administrative abilities to meet contract requirements? If no, please explain.

1. Did the contractor provide adequate staffing levels with qualified personnel to meet contract requirements? If no, please explain.

CONTRACT PERFORMANCE EVALUATION

Based upon the assessment definitions above, indicate your assessment of the contractor’s performance on your contract described on Attachment 4. Your assessment should consider the contractor’s performance in accordance with the contractual requirements. Circle all that apply.

COMPLIANCE WITH ENVIRONMENTAL, SAFETY,

HEALTH AND SECURITY REQUIREMENTS

How well did the contractor comply with local, State, and Federal environmental standards?

SAT

Overall rating for compliance with environmental, safety, health, and security requirements.

SAT

Has the contractor ever violated any local, State and/or Federal environmental standards?

Yes

N/A

Did the contractor comply with reporting and responding procedures and perform all requirements for spills or releases to include accepting all liability as defined in the SOW? If no, please explain.

Yes

N/A

Did the contractor comply with all licensing, certification requirements for personnel, equipment, and vehicles? If no, please explain.

Yes

N/A

Has the contractor ever violated any security or safety standards? If yes, please explain.

Yes

N/A

Have the contractor or contractor employees ever been involved in any verbal or physical altercations on the work site? If yes, please explain.

Yes

N/A

CONTRACTOR’S NAME: __________________________

CONTRACT NO.: ___________________________

OVERALL RATING: ______________________________

BRIEF EXPLANATION OF OVERALL RATING GIVEN:

ADDITIONAL COMMENTS

Name of Person Completing Evaluation:

Base/Company: Date:

Position Title/Grade: Phone:

Email: Fax:

File details come from the government source that posted it. Updated Nov 14, 2017.