Attachment_2-_Past_and_Present_Performance_Questionnaire.docx

For Official Use Only When filled in, this document is Source Selection Sensitive Information IAW FAR 2.101 and 3.104.

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

SUBJECT: Request for Past Performance Evaluation

TO: _______________________________________

The 1st Special Operations Contracting Squadron at Hurlburt Field, FL is in the process of competitively selecting a contractor for the Grounds Maintenance Services contract at Hurlburt Field, FL.

One of the considerations in the evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your written response no later than 2:00 PM CDT on 20 May 2019. This schedule will allow us sufficient time to analyze the data.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to goldie.silvestre.1@us.af.mil and charles.carnley@us.af.mil.

Your prompt attention to this questionnaire is greatly appreciated. For questions, please contact 2d Lt Goldie J. Silvestre at (850) 884-7691 or Mr. Charles Carnley at (850) 884-1258.

Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Program Description:

G. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

H. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

I. Description of work performed:

J. Total acreage of grounds maintenance area:

K. Was work done on and around an active airfield? If yes, how many acres?

L. Was this a competitively awarded contract? ☐ Yes ☐ No

M. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

Note: If offeror holds or has held other contracts for Credential Services with your agency/organization in the last three (3) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone/fax number/e-mail address:

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

E. Other suggested points of contact:

Section 4: Performance Information

In the table below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E Exceptional – Performance meets/met contractual requirements with many exceeded to the respondent’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.

G Good – Performance meets/met contractual requirements with some exceeded to the respondent’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.

S Satisfactory – Performance meets/met 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.

M Marginal – Performance does not/did 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.

U Unsatisfactory Performance does not/did 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.

N/A Not Applicable – Performance was not observed or not applicable to the current effort being reported against.

FA441719QA012

Attachment 2

YES / NO

YES / NO

YES / NO

YES / NO

YES / NO

Additional remarks:

Click for date

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

E-Mail to: goldie.silvestre.1@us.af.mil and charles.carnley@us.af.mil

FA441719QA012

Attachment 2