J-5_Past_Performance_Questionnaire.pdf

DEPARTMENT OF THE AIR FORCE

HEADQUARTERS AIR MOBILITY COMMAND

JOINT BASE MCGUIRE-DIX-LAKEHURST

FOR OFFICIAL USE ONLY

DATE:

FROM: 87 Contracting Squadron 2402 Vandenberg Avenue Joint Base McGuire-Dix-Lakehurst, NJ 08641

SUBJECT: Request for Past Performance Evaluation for _____________________; Request for Proposal (RFP) Number FA4484-14-R-0006

Dear Sir orMadam:

You are requested to answer the attached Past Performance Questionnaire in respose to a solicitation issued by the 87th Contracting Squadron. It is stressed that this questionnaire be filled out by the addressee and not the Offeror, and that the information be forwarded to the Government individual identified below. DO NOT RETURN

YOUR RESPONSE TO THE CONTRACTOR THAT FORWARDED THIS QUESTIONNAIRE TO YOU.

One of the considerations in proposal evaluation is the verification of the offerors' past and present performance on contracts, which reflect the offeror's ability to perform on the proposed effort. We depend on information received from agencies such as yours, which have had firsthand experience with an offeror, for the evaluation of the offeror's performance on those contracts.

Our areas of interest in the offeror are summarized in the enclosed questionnaire. Our schedule is extremely tight and we need your written response no later than 5 calendar days after your receipt of this letter. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out by hand and "faxed" to 609-754-4642 (Attention: SSgt Karl Knott) or emailed to karl.knott@us.af.mil.

Please call SSgt Knott at 609-754-3956 prior to fax transmission or if you have any questions. Your completed questionnaire will become a part of the official Source Selection records.

Your help is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

//SIGNED//

SUZANNE M. EDGAR

Contracting Officer

Enclosed: Past Performance Questionnaire

Attachment 1

PAST PERFORMANCE QUESTIONNAIRE

RFP FA4484-14-R-0006

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

Contractor’s Name: ___________________________________________________________________________

Address: ______________________________________________________________________________________

Telephone Number: _______________________________ Fax Number: ________________________________

Point of Contact: ____________________________________________________________________________

Project Title and Brief Description of Work: ________________________________________________________

Contract Number Provided: ________________________________ Dollar Amount: $____________

If this is an indefinite delivery and quantity contract or similar, please state the average number of orders annually and the dollar range and average dollar amount per order:

Period of Performance Provided ____________________________________________ Contractor performed as the Prime Contractor SubContractor Key Personnel. If performed as a subcontractor, please provide the percentage and type of work performed.

Place of Performance: ________________________________________________________________________

* 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: ________________________________ Address: ______________________________________________________________________________________ Telephone Number: _______________________________ Email: ______________________________________

C. EMAIL COMPLETED SURVEY FORM TO: karl.knott@us.af.mil

If you have any questions, please contact SSgt Karl Knott at 609-754-3956 or David Fenick at 609-754-2837.

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (SU, SA, L, N and NA) that most accurately describes the contractor’s performance or situation.

SU SA L N N/A

Substantial Confidence Satisfactory Confidence Limited Confidence No Confidence Not Applicable mailto:karl.knott@us.af.mil

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

The contractor/subcontractors: SU SA L N NA

1.

Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2.

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

3.

Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Followed approved quality control plan.

5.

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

6.

Corrected deficiencies in timely manner and pursuant to their quality control procedures.

7. Provided timely resolution of contract discrepancies.

8. Identified problems as they occurred.

9. Suggested alternative approaches to problems.

10.

Displayed initiative to solve problems without extensive customer guidance.

11. Was responsive to contract changes.

12. Provided adequate project supervision.

13. Paid subcontractors/suppliers in a timely manner.

14.

Provided accurate and complete line item cost proposals including all aspects of work required for each task.

The contractor/subcontractors: SU SA L N NA

15. Cooperated with the customer after award.

16. How would you rate the contractor's overall performance?

17.

Was the contractor ever issued a cure or show cause notice under the referenced contract or are any terminations pending? If yes, explain outcome in “remarks.”

YES/NO

18.

Would you award another contract to this contractor? If not, explain in “remarks.” YES/NO

Remarks:_____________________________________________________________________________________

Thank you for your assistance in supporting this source selection activity.