Attachment_6_Past_Performance_Questionnaire.pdf

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

Past Performance Questionnaire

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The 87th Contracting Squadron of the Air Force in the process of competitively selecting a source for Preventative Maintenance of Boiler Controls.

One of the considerations in proposal 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 September 14, 2018 at 1:00pm EST.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to angelica.hibbert@us.af.mil or by hand and faxed to 609 754-4948 (Attention: Ms. Angelica Hibbert). Please call Ms. Hibbert at 609 754-2403 prior to fax transmission or if you have any questions.

Your assistance and your prompt response will be is greatly appreciated.

CHRISTINE T. LEHTINEN

Contracting Officer

1 Atch

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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. Period of Performance

F. Contract Dollar Value

G. Description of work performed:

H. How is this requirement relevant to the solicitation?

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

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

Section 2: Customer or Agency Identification

A. Customer or agency name:

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

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

D. Respondent’s position (e.g., Program Manager, PCO/ACO, etc.):

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Section 4: Performance Information

In the tables 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 contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the

Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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 meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

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Performance E V S M U N/A

1. Did the contractor provide boiler maintenance on boilers that are more than or equal to 5Mmbtu/hr?

SUPPORTING INFORMATION:

2. Did the contractor personnel possess the ability to read, interpret, and understand blueprints, specifications, procedures, diagrams, and sketches for the repair and installation of pressure vessels and associated components; and the knowledge of trade theory, work practices, processes, and materials for high pressure boilers

3. Do the contractor employees have a minium of three years experience working on boilers that are more than or equal to 5Mmbtu/hr?

4. Did the contractor provide preventative maintenance and repair boiler controls, read, reset and tune boiler burner assemblies, and test boiler stack emissions?

5. Was the contractor knowledgeable about maintaining and repairing boiler controls, reading, reseting and tuning boiler burner assemblies, and testing boiler stack emissions?

6. Did the contractor provide written reports that listed preventative maintenance actions, and repair completion reports that included deficiencies, actual parts replaced, cost of parts, man-hours per repair?

7. Did the contractor perform preventative maintenance and repair boiler controls, read, reset and tune boiler burner assemblies, and test boiler stack emissions on time?

8. Did the contractor respond to service calls in timely manner?

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9. Did the contractor repair all mechanical/electrical/control/safety deficiencies as a result of the preventative maintenance/inspection/testing/certification, and load testing procedures as well as service calls?

10. How timely and effectively did the contractor resolve contract problems without extensive Government guidance?

11. How successfully did the contractor respond to emergency situations?

12. Overall, how would you rate this contractor?

Government Contracts Only: Was this contract partially or completely terminated for default or convenience, or are there any pending terminations?

☐ Yes ☐ Default ☐ Convenience ☐ Pending Terminations ☐ No

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules).

SECTION 5: GENERAL COMMENT

Given what I know today about the contractor’s ability to execute what he promised in his proposal, I ___________________ (would/would not) award to him today given that I had a choice.

REMARKS:

Please provide any additional comments concerning this contractor’s performance, as desired.

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Respondent’s Signature & Phone Number Date

Thank you for your prompt response and assistance!