FA3047-12-R-0026 Attachment 6 Past Performance Questionnaire.doc

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION – PAST PERFORMANCE

LACKLAND AFB FULL FOOD SERVICE

PAST PERFORMANCE SURVEY IN RESPONSE TO

SOLICIATION NO. FA3047-12-R-0026

Name of firm to be evaluated: ____________________________________________________

The above contractor has identified you or your (Agency) company as a reference for past performance information for the above referenced solicitation. Please complete this survey, evaluating the contractor’s performance under your contract and return it by fax or email to Lois Ward, Contract Administrator, telephone 210-925-9124, fax 210-671-1199, email lois.ward.1@us.af.mil. If returning by fax, please call to confirm receipt of fax.

It is requested that you complete the following information and provide your assessment.

Thank you for your assistance in the Past Performance evaluation process!

Name & Title of Evaluator:_______________________________________________________

Organization Name: __________________________ Phone No: ________________________

Type of Services Provided: ______________________________________________

Contract Number: ______________________________________________________

Total Contract Amount (includes mods and options): $____________________

Period of Performance Including Option Years (exact dates):____________________________

Please circle which efforts were performed under this contract:

1. Food Preparation

4. Menu Posting

7. Compliance w/Sanitation Requirements

2. Food Serving

5. Table Bussing Service

8. Housekeeping Service

3. Food Ordering

6. Cashier Service

9. Field Operations

Evaluation Scoring Definitions:

CODE

PERFORMANCE LEVEL

EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD- The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or was satisfactory.

MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

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

N/A

NOT APPLICABLE - Unable to provide a score.

NOTE: When indicated, please circle the appropriate number associated with the above adjective, for ratings below satisfactory, please comment.

1. Contractor’s Performance:

a. Food prepared

5 4 3 2 1 n/a

b. Serving of food

c. Ordering of food

d. Menu posting

e. Table bussing

f. Cashier service

g. Compliance with sanitation requirements

h. Housekeeping service 5 4 3 2 1 n/a

i. Field operations 5 4 3 2 1 n/a

COMMENTS: ____________________________________________________________

2. Management & Resources: Adequate personnel, training, equipment and supplies/materials

a. Adequacy of on-site supervisor’s authority

b. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period

c. Compliance with rules, regulations and support of Agency/base programs/policies

(i.e. EEO, Sexual Harassment, Emergency Management)

d. Personnel were well groomed, trained, and possessed expertise necessary for successful performance

e. Contractor’s invoices/reports submitted on time

f. Personnel were trained and possessed expertise necessary for successful contract performance

g. Ability to follow and monitor the Quality Control Plan

h. Care for facilities and equipment provided for use under contract (maintenance, repairs, reporting damage)

i. Meal service during an emergency or contingency operation

j. Flexibility and reasonableness with meeting mission requirements, particularly when faced with short notice mission changes

COMMENTS: ____________________________________________________________

3. Quality of Work and Timeliness: Services performed timely

a. Patrons served IAW scheduled times

b. Cure or Show Cause ever issued for late/nonperformance

c. Contractor compliance with Work Statement

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

e. Corrected deficiencies in timely manner

4. Competence/Customer Satisfaction:

a. Overall customer satisfaction

b. Options not exercised due to poor performance. If yes, comment below Yes No

c. Contract Discrepancy Reports issued

d. Discrepancies were corrected satisfactorily. If no, comment below

e. Recommend doing business with this contractor

Please provide any additional information you feel is important and not covered elsewhere*:

*If applicable, please reference the appropriate question number.

Thank you for your remarks, and be sure to return this form to the Contracting Agency and not to the Contractor you are providing a reference for.

Name of Company Being Evaluated: _________________________

Respondent’s Signature: ___________________________________

Date Completed: _________________