Attach_4_PP_Questionnaire.docx

FOR OFFICIAL USE ONLY

SOURCE SELECTION SENSITIVE

FA4417-15-R-0036 Attachment 4

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: ____________________ Telephone Number: ____________________ Address: __________________________ Fax Number: _________________________ __________________________ 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: ____________________________

C. EMAIL COMPLETED SURVEY FORM TO: Mr. Michael Wenrick at 850-884-6007 michael.wenrick@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 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 were 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: _______________

Place a “X” on whether your contract included the following services (This section is used to help determine relevancy).

Access to DoD/DoJ approved ARMAG weapons & sensitive items armory

Flat shooting ranges capable of supporting steel, wood, and paper targets out to distances of 100 meters.

Extended Distance Ranges supporting targets set up at known and unknown distances to and past 1000 meters.

Training area to conduct a Final Training Exercise (FTX) and Full Mission Profiles (FMP).

Facility capable of supporting Close Quarters Battle training.

Mission Planning Facility accessible to students 24 hours a day.

Training area capable of supporting breaching operations with det cord, time fuse, and C4

Training area must be able to accommodate training on how to detonate explosives in place as opposed to disarming them.

Strength and Conditioning Training Facility.

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

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