Past_Performance_Questionnaire.doc

CONTRACTOR: [CONTRACTOR INSERT NAME]

SOLICITATION NUMBER: FA3016-16-R-0009

TO: [CONTRACTOR INSERT RESPONDER’S NAME]

SUBJECT: Request for Past Performance Evaluation

You have been identified as a point of contact for a past performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for a Trainer Maintenance Service at Joint Base San Antonio, Lackland.

Questionnaires are due by 1100 AM CST May 9, 2015. Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, please contact the Contract Specialist or Contracting Officer, michael.doerr@us.af.mil or robert.delarosa.1@us.af.mil respectively.

Attachment:

Past and Present Performance Questionnaire

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION:

Contractor’s Name: ____________________ Telephone Number: ____________________

Address: __________________________ Point of Contact: ______________________

Project Title and Brief Description of Work: ______________________________________*

Contract Number Provided by Offeror: ___________________ Dollar Amount: __________*

Contract Period or Dates of Performance Provided by Offeror: ________________________* Contractor performed as the ( Prime Contractor ( Sub-Contractor ( Key Personnel.

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

B. RESPONDENT INFORMATION:

Name of Respondent:

_____________________ Title: ____________________________

Address: __________________________ Point of Contact: ______________________

__________________________ Fax Number:

Email Address: _____________________

C. E-MAIL COMPLETED SURVEY FORM TO:

Contract Specialist: Michael V. Doerr/SSgt/USAF michael.doerr@us.af.mil Contracting Officer: Robert De La Rosa robert.delarosa.1@us.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.

Performance meets/met contractual requirements with many exceeded to the Government’s benefit. 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 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.

Remarks

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104