Past_Perf_Questionnaire_22_Oct_14.docx

DEPARTMENT OF THE AIR FORCE

87TH AIR BASE WING (AMC)

22 Oct 14

FROM: 87 CONS/LGCC

2402 Vandenberg Ave Joint Base McGuire-Dix-Lakehurst, NJ 08641-1712

SUBJECT: Request for Past Performance Evaluation

1. You have been identified as a point of contact for a past and/present performance evaluation of the firm listed on the attached survey. This firm is currently being considered for a full food service contract at Joint Base McGuire-Dix-Lakehurst.

2. Please respond to this survey no later than 15 Dec 14. If you have any questions concerning this request, please contact Michael Petty at 609-754-4768. Please fax all completed surveys to 609-754-4642 or scan and email to michael.petty.5@us.af.mil.

\\SIGNED\\

KAREN THORNGREN

Contracting Officer

Attachment:

Past and Present Performance Survey

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 5 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ____________________________

Address: _____________________ Telephone Number: ____________________

_____________________________ Fax Number: _________________________

_____________________________ Email Address: _______________________

C. FAX/EMAILCOMPLETED SURVEY FORM TO: 609-754-4768 and/or michael.petty.5@us.af.mil

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (O, S, M, U or NA) 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. 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 Name: _______________________ Contract Number.____________________

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

The contractor:

YES/NO

YES/NO

Remarks:

FA4484-15-R-0005

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