ITO Attachment 1.3 Past Performance Questionnaire.docx

ATTACHMENT - INSTRUCTIONS TO OFFERORS (ITO) FOR EGLIN, AFB EXTERIOR AND INTERIOR PAINTING IDIQ

ITO ATTACHMENT 1.3

Past Performance Questionnaire

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

Contractor: _________________________________

Cage Code of contractor contract was awarded to: _________________________________

Contract number: _______________________________________

Contract type: ______________________________ (If multiple types (i.e. Firm-Fixed Price with Time & Material), list percentage and dollar amount of Firm-Fixed Price portion)

Contractor performed as: Prime Contractor _____ Sub-Contractor _____

Was this a competitive contract? Yes _____ No _____

Did this contract include exterior and/or interior painting? Yes _____ No _____

Period of performance: _________________________________________________________

Initial contract price: $____________________________

Current/final contract price: $_______________________________

Reasons for differences between initial contract price and final contract price: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Description of service provided: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

Customer or agency name: _________________________________________________________________

Customer or agency description (if applicable): _________________________________________________________________

Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3. EVALUATOR IDENTIFICATION

Evaluator's name: _________________________________________________________________________________ Evaluator's title: __________________________________________________________________________________

Evaluator's phone/fax number: ______________________________________________________ Evaluator’s email: __________________________________________________________________

Number of years evaluator worked on subject contract: ___________________________________

SECTION 4: EVALUATION

PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation.

Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

Performance meets contractual requirements with some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor was effective.

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

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

Place an “X” in the appropriate column using the definitions matrix above.

YES/NO

PLEASE PROVIDE A NARRATIVE SUMMARY FOR ANY RATINGS OF M or U.

Government Contracts Only: Has/was this contract partially or completely terminated for default or convenience or are there any pending terminations?

No ___ Yes___ for Default___ Convenience___ Pending Terminations___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION 5: NARRATIVE SUMMARY

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

Evaluator’s Signature Date__________________________

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

DEPARTMENT OF THE AIR FORCE

AFTC/PZIOC ATTN: Ronald Wilson / Timmothy Allred Eglin, AFB FL 32542 ronald.wilson.22@us.af.mil and timmothy.allred@us.af.mil

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