ATCH 3 - Revision 1 - A-E Past Performance Questionnaire - 01 July 24.pdf

FA309924Q1013

ATCH 3 – Revision 1

01 July 2024

PAST PERFORMANCE QUESTIONNAIRE

The contractor listed below is being considered in a competitive acquisition by the 47th Contracting Squadron. Please complete this Questionnaire and submit on or before __11 July 2024___. Send completed questionnaires to: 47 CONS/PKA, Attn: SrA Ruth Elias-Hernandez email (ruth.elias_hernandez@us.af.mil) or Javier Hinojosa (javier.hinojosa.4@us.af.mil), with a copy to Contracting Officer Juanita Vasquez (juanita.vasquez.3@us.af.mil). Your comments are considered CONTROLLED UNCLASSIFIED INFORMATION (CUI). Therefore, you are advised that the Procurement Integrity Act prohibits the release of the names of individuals providing the reference information about an offeror’s past performance. In order to maintain the integrity of the acquisition process, it is requested that you do not divulge the name of the contractor or discuss your comments on this questionnaire with any other individuals.

Past Project Information (completed by firm)

1. Offeror

2. Address

3. Phone Number

4. Firm being evaluated (offeror or team subcontractor)

5. Contract Number/Project Title being evaluated

Evaluator (completed by firm)

1. Name of Evaluator

2. Email Address

3. Firm/Agency Name and Address

4. Phone Number

5. Position held or function in relation to project

Rating: Please evaluate the contractor’s performance using the following ratings only (completed by evaluator):

“E” Excellent Performance exceeds contractual requirements. The contractual performance of the element being assessed was accomplished with few minor or no minor problems for which corrective actions taken by the contractor are/were highly effective.

“S” Satisfactory Performance meets contractual requirements. The contractual performance of the element contains some minor problems for which corrective action(s) taken by the contractor are/were satisfactory.

“M” Marginal Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a moderate problem(s) for which the contractor has not yet identified corrective actions. The corrective action(s) taken by the Contractor’s proposed actions are/were marginally effective or were not fully implemented.

“P” Poor Performance does not meet most contractual requirements and delivery is not likely in a timely manner. The contractual performance of the element contains serious problem(s) for which the contractor’s corrective actions are/were ineffective.

“N” Neutral No relevant past performance record is identifiable upon which to base a meaningful performance risk prediction. A search was unable to identify any relevant past performance information for the contractor or their key personnel. (This is neither a negative nor positive assessment) mailto:ruth.elias_hernandez@us.af.mil mailto:javier.hinojosa.4@us.af.mil

“N/A” Not Applicable Not applicable to this project Do not rate on a plus (+) or minus (-) scale. Please use only the ratings provided above, without variation

PAST PERFORMANCE QUESTIONNAIRE (continuation sheet)

Please rate and provide any supporting information for the following:

1. Cost Control and Cost-Effective Performance: Rating:

a. Ability to track and control expenditures, invoiced costs and projected costs.

b. Reasonableness, timeliness and accuracy of cost/price proposals and supporting data

c. Initiative to minimize project costs.

Comments:

2. Quality Control with Contract Specifications and Schedules: Rating:

a. Quality of work (technical, professional and environmental).

b. Quality of data submittals and reports.

c. Ability to manage and track government property (if applicable).

3. Schedule Control: Rating:

a. Ability to manage schedule timeliness of products and services.

b. Timeliness of data submittals and reports.

4. Compliance with Law and Regulations: Rating:

a. Adequacy of responses to regulator comments and concerns.

b. Effectiveness in interfacing with regulators, concerned community groups and stakeholders.

c . Compliance with safety standards and/or number of safety related incidents.

5. Performance

a. Would you award another contract to this contractor?

If not, please indicate why:

If yes, please indicate why:

Yes: ___________ No:____________

b. Has the Contractor been provided an opportunity to discuss any negative performance ratings? If so, what were the results?

Yes: ___________ No:____________

PAST PERFORMANCE QUESTIONNAIRE (continuation sheet)

Please provide any additional applicable comments regarding the contractor’s performance:

OVERALL RATING:_________________