Atch 6 - Past Performance Survey and Reference Letterdemo.doc

FA4427-08-R-0105

FOR OFFICIAL USE ONLY

DEPARTMENT OF THE AIR FORCE

60TH CONTRACTING SQUADRON (AMC)

MEMORANDUM FOR (Contractor please add reference information)

FROM: 60 CONS/LGCA

350 Hangar Ave Bldg 549

Travis AFB, CA 94535-2632

SUBJECT: Request for Past Performance Questionnaire Information for FA4427-08-R-0105, Natural Gas System Repair at Travis AFB, CA

1. You have been identified as a reference point of contact for past and/or present performance evaluation of the firm listed on the attached questionnaire form. This firm is currently interested in providing a proposal for a Natural Gas System Repair Requirements contract at Travis AFB, CA.

2. Please complete the attached survey questionnaire not later than _27 August 2008_. You should e-mail the survey back to Edward Emmons at edward.emmons@travis.af.mil send a courtsey copy to Gerald Napiewocki at Gerald.Napiewocki@travis.af.mil You may fax the questionnaire to (707) 424-5189. If you have any questions, please contact Edward Emmons at (707) 424-7763 or Gerald Napiewocki at (707) 424-7769. Your information MUST be submitted by _27 August 2008. Your expedient attention regarding this matter is greatly appreciated. Thank you in advance.

GERALD NAPIEWOCKI

Contracting Officer

PRESENT AND PAST PERFORMANCE QUESTIONNAIRE

Solicitation Number FA4427-08-R-0105 Natural Gas System Repair at Travis AFB, CA

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

A. GENERAL INFORMATION: Contractor please complete block A before sending to your reference (Please correct any information below known to be inaccurate):

Contractor’s Name:

Address:

Telephone Number:

Fax Number:

Point of Contact:

Project Title or Brief Description of Work:

Contract Number Provided by Offeror: Dollar Amount: $

Contract Period or Dates of Performance Provided by Offeror:

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.

Contractor performed as the ( Prime Contractor ( Sub-Contractor ( Key Personnel.

B.

RESPONDENT INFORMATION:

Name of Respondent:

Title:

Company:

Address:

Telephone Number:

Fax Number:

Email Address:

C. Email Completed Questionnaire Form Not Later Than 27 August 2008 To:

Edward Emmons Gerald Napiewocki

Edward.emmons@tavis.af.mil Gerald.Napiewocki@travis.af.mil D. PERFORMANCE INFORMATION: Circle the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

Based on the offeror’s performance record:

CONTRACTOR’S NAME: _______________________ CONTRACT NUMBER ________________

The Contractor…

N U M S G E

PERFORMANCE/PROGRAM MGMT

1. Upon award the contractor was timely in

N/A fulfilling contract requirements (submitting documents, starting work, submitting materials

& acknowledgements, etc)?

2. Cooperated with owner/government personnel

N/A after award.

3. Demonstrated ability to hire, maintain &

N/A replace if necessary, qualified personnel during the contract period.

4. Provided experienced employees with the N/A technical & administrative abilities to meet contract requirements.

5. Provided material submittals in accordance N/A with the contract requirements.

6. Provided payrolls in a timely manner.

N/A

7. Maintained a single point of contact to

N/A manage and resolve problems.

8. Provided adequate employee supervision.

N/A

9. Company headquarters participated in solving N/A significant local problems.

10. Corrected deficiencies in timely manner & N/A pursuant to their quality control procedures.

11. Met established turn around times

N/A for required periodic contract reports, etc.

12. Identified risks/problems as they occurred.

N/A

13. Suggested alternative approaches to problem.

N/A

14. Was responsive to contract changes.

N/A

15. Effectively managed sub-contractor

N/A efforts.

16. Do you have any reservations about

Yes ( )

No ( )

N/A ( ) having this contractor perform another contract for you? (If yes, please explain under “remarks”.)

CONTRACTOR’S NAME: _______________________ CONTRACT NUMBER ________________

17. Rate the contractor’s overall performance N/A under this contract.

EMPLOYEE RETENTION

1. Demonstrated ability to retain a qualified

N/A workforce.

INVOICING & PROGRESS REPORTS

1. Provided accurate and timely invoices.

N/A

2. Provided accurate and timely progress reports N/A

ORGANIZATION

1. Has demonstrated good organizational

N/A structure and accountability.

2. If there were problems with the on site supervision, Yes ( )

No ( )

N/A ( ) were you able to easily resolve those problems with the company’s management? (Please explain under “remarks”.)

3. Are you aware of any documented organizational

N/A ( ) deficiencies with the contractor?

(If yes, please explain under “remarks”.)

LEGAL

1. Are you aware of any legal problems experienced by

Yes ( )

No ( )

N/A ( ) the contractor? (Please explain under “remarks”.)

2. Are you aware of any verified ethical problems

N/A ( ) experienced by the contractor? (Please explain under “remarks”.)

GOVERNMENT CONTRACTS ONLY

1. Was the contractor ever issued a cure notice

N/A ( ) or show cause? If yes, explain outcome in “remarks”.

2. Has the contract been partially or completely terminated

Yes ( )

No ( )

N/A ( ) or is the contract pending termination?

2a. If you answered “YES” to question #2, please explain under “remarks”.

3. Has an election ever been made to not exercise an option due to contractor’s performance.

N/A ( ) If yes, explain in “remarks”.

3. Was there any specific delivery order that had problems?

(please explain under “remarks”

N/A ( )

CONTRACTORS NAME:_________________________CONTRACT NUMBER______________________

NARRATIVE SUMMARY

1. What were the contractor’s greatest strengths in performance of the contract?

CONTRACTOR’S NAME:_______________________ CONTRACT NUMBER_________________

2. What were the contractor’s greatest weaknesses in performance of the contract?

Please add any additional comments concerning this contractor’s performance.

Remarks:

Please provide the Name, Organization, e-mail and phone number of the Inspector on this contract in the blocks below.

(Name) (Organization) (E-mail) (Phone Number)

PAGE

Attachment 5