Attachment 4 - Past Performance Questionnaire

DEPARTMENT OF THE AIR FORCE

AIR EDUCATION AND TRAINING COMMAND

FOR OFFICIAL USE ONLY

MEMORANDUM FOR PROJECT OWNERS

FROM: AETC CONTRACTING SQUADRON/LGCS

2021 First Street West

Randolph AFB, TX 78150-4302

SUBJECT: Past Performance Questionnaire

1. One of the integral considerations in proposal evaluations is the verification of the offeror’s past and present performance on contracts, which reflect the offeror’s ability to perform. We depend on information received from agencies such as yours that have had firsthand experience with the offeror, and for the evaluation of their performance. Therefore, we request the attached questionnaire be completed concerning the offeror’s past and present performance.

2. The Government’s areas of interest in the offeror are summarized in the enclosed questionnaire.

Because of your association with the offeror, you are encouraged to submit supporting comments in addition to your ratings on Resource Management for Refuse Collection Services and Recycling

Services or similar programs for which your activity has contracts or administers contracts with the offeror. Any additional information you think would benefit the Government in our evaluation of the offeror’s proposal would be appreciated. Please note we may contact the offeror on problems or areas of concern identified to see what corrective actions have been taken or will be taken. Even though the offeror was required to provide points of contact for each reference provided to the

Government, the individual’s name completing this questionnaire will not be disclosed to the offeror.

3. The offeror will need to fill out sections A and B then forward to the applicable agencies for validation. Each agency will complete the questionnaire and return it to the points of contact listed below. Please be advised that once this document is filled out it is Source Selection Sensitive IAW

FAR 2.101 and FAR 3.104.

4. Due to time constraints, it is imperative that the questionnaire be completed and returned via e-mail not later than 27 October 2009 to Capt Michelle Adams at michelle.adams@randolph.af.mil and aetc.iswm.at@randolph.af.mil. All documents should be marked Source Selection Sensitive/For

Official Use Only.

5. If additional information is required, do not hesitate to contact me at michelle.adams@randolph.af.mil or (210) 652-3201.

//SIGNED//

MICHELLE R. ADAMS, Capt, USAF mailto:michelle.adams@randolph.af.mil mailto:aetc.iswm.at@randolph.af.mil

FA3002-09-R-0035

Attachment 4

FO R O FFICIAL USE O NLY

SO URCE SELECTIO N SENSITIVE INFO RMATIO N

Contracting Officer, CFCM

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: The contractor is to completely fill out Sections A and B. The contracting agency will verify the information, highlight any discrepancies and add additional information, if necessary:

Contractor’s Name/Cage Code: ____________________ Telephone Number: ______________________

Address: __________________________ Fax Number: ______________________

__________________________ Point of Contact: ______________________

Project

Title_______________________________________________________________________________

Complete Description of Work

Explain corrective actions taken in the past, if any, for substandard performance and any current performance problems such as cost overruns, extended performance periods, numerous warranty calls and comments regarding compliance with contract terms and conditions, etc.

Contract Number Provided by Offeror: ___________________ Dollar Amount Per Year of Contract: ________

Contract Period or Dates of Performance: ______________________

Recycling Revenue Generated Per Year: ___________

Percentage Increase in Recycling Volume and Revenue Per Year: _____________

Annual Diversion of Non-hazardous Solid Waste: _________ Type of Commodities Recycled: _____________

Number and Size of Dumpsters: _______ Type and size of equipment used for recycling:_____________

Number of Pick-ups: Weekly____Monthly____Annually______

Annual Tonnage: __________ Composting Facility: Yes/No

Solid Waste: ________ If yes, what type_________________

Food Waste: __________

Recyclable Commodities: ________

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

B. RESPONDENT INFORMATION: This information must be provided and verified by the contractor prior to submitting the contracting agency to ensure the information is up-to-date.

Contracting Agency/Customer Name:_____________________ Title: ____________________________

Address: _____________________ Telephone Number: ____________________-

_____ _____________________________ Fax Number:

_____________________________ Email Address: _________________________

C. E-MAIL COMPLETED SURVEY FORM TO: michelle.adams@randolph.af.mil and aetc.iswm.at@randolph.af.mil

D. 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 . PLEASE PROVIDE A NARRATIVE

EXPLANATION FOR ANY RATINGS OF M or U.

E G S M U N

Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets contractual requirements with many exceeded to the Government’s benefit . The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to the Government’s benefit . The contractual performance of the element or sub-element being assessed was accomplished with no more than 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 or 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.

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

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

The contractor: E G S M U N

1. Demonstrated the ability to mobilize with minimum initial investment costs.

Comments:

2. Provided creative ways to reduce, reuse and recycle commodities in remote locations and metropolitan areas .

mailto:aetc.iswm.at@randolph.af.mil

3. Demonstrated ability to process recycling commodities in a manner that maximizes revenue.

4. Demonstrated ability to reduce solid waste disposal tonnages associated with non-revenue generating commodities.

5. Demonstrated ability to maximize recycling revenue by optimizing facility space for staging to accumulate recyclable commodities.

6. Demonstrated capability to implement and sustain continuous improvement in diversion processes and recycling revenue generation throughout the duration of performance.

7. Reported accurate and timely information to the user for weight tickets, landfill receipt, diversion metrics and recycling revenue receipts.

8. Demonstrated ability to reduce program costs throughout the life of the program by increasing diversion and maximizing recycling sales.

9. Ability to forecast equipment maintenance requirements, avoiding excessive equipment down time.

10. Ability to ensure consistent operations during equipment failure or maintenance.

11. Demonstrated the capability to cost effectively implement EPA certified Resource Management processes.

12. Properly disposed of waste.

Comments:

13. Provided effective quality control and/or inspection procedures to meet contract requirements.

14. Identified problems as they occurred.

Comments:

15. Suggested alternative approaches to mitigate problems.

Comments:

16. Met established project schedules including mobilization, pick-up schedules, unscheduled pick-ups, etc.

17. Was able to forecast and control cost.

Comments:

18. How would you rate the contractor's overall performance? Please summarize their performance in the comment section below.

19. Would you award another contract to this contractor? If not, please explain. YES/NO

Comments:

20. Did you have to initiate adverse action against the contractor for correction to ensure compliance? If yes, please explain.

YES/NO

CONTRACTOR’S NAME: ___________________ CONTRACT NUMBER _______________

Remarks:_______________________________________________________________________________