Atch_3_Past_Performance_Questionaires.pdf

The United States Air Force has requested offerors responding to solicitation FA2835-16-R-0002 include relevant past performance references with their proposal to this requirement.

The offeror is to complete Section A identifying the contract and has forwarded this form to you for completion. Please complete Section B and return this past performance attachment to the Contract Specialists hyun.townsley.1@us.af.mil and william.engelhart.1@us.af.mil and Contracting Officer jason.bergeron.3@us.af.mil no later than 2pm EST on 27 January 2016.

Evaluation

In Section B indicate the contractor’s past performance for each category area below and provide an overall evaluation at the end. Provide rationale, including specific examples, as appropriate, to support your ratings in the space provided for comments for each category area. TABLE 1- Definition of Services to be evaluated and TABLE 2 – Performance Rating Definitions are provided at the end of this document to guide you through the evaluation.

SECTION A – TO BE COMPLETED BY OFFEROR

Ambulance Contractor

d. Contract Number:

BPA Number:

Order Number:

e. Prime or Subcontractor:

f. Dollar Amount:

(If final amount different from award amount, please provide an explanation for change in award amount.)

Date Completed:

d. Contract Type: Fixed Price __ Cost Reimbursement __Other (Specify)

h. Item/Service Description:

Be specific here as references must be determined to be relevant to the solicitation to be evaluated.

The Contractor shall provide full emergency patient transport services at Hanscom AFB, all associated housing areas, and the Hanscom AFB Family Campground Area, South Street, Bedford MA.

g. Contract Period of Performance: Start Date: End Date:

a. Customer/Business/Agency Name:

b. Customer POC (Note: Ensure POC information is valid and current)

Name:

Address:

c. Phone:

c. E-mail:

mailto:hyun.townsley.1@us.af.mil mailto:william.engelhart.1@us.af.mil mailto:jason.bergeron.3@us.af.mil

SECTION B - PERFORMANCE EVALUATION TO BE COMPLETED BY PAST

PERFORMANCE REFERENCE AND SUBMITTED TO USAF.

Ambulance Contractor

Category (please provide a narrative to support the rating chosen)

Ratings

1. Quality of Service: __Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

__Not Rated

2. Schedule: __Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

__Not Rated

3. Business Relations __Exceptional

__Very Good

__Satisfactory

__Marginal

__Unsatisfactory

__Not Rated

TABLE 4 – OVERALL PERFORMANCE RATING

(Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, Not Rated)

TABLE 2 – Performance Rating Definitions

Rating Description

Exceptional Performance meets contractual requirements and exceeds many to the Government's benefit. The element being assessed was accomplished with no problems.

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.

TABLE 1- Definition of Services to be evaluated

Rating Description

Quality of

Service

Assessment based on the contractor’s conformance to contract requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards).

Schedule Assessment based on the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance).

Business

Relations

Assessment based on the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts.