Past_Performance_Questionaire.doc

Attach. 2 Past Performance Questionnaire

RFQ No: FA4486-15-T-0003

PAST/PRESENT PERFORMANCE

EVALUATION QUESTIONNAIRE

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. The offeror shall forward a copy of this questionnaire to at maximum four (4) agencies whom the offeror has been contracted for similar services with the Federal, State, and Local Government or from private industry sources during the past three (3) years. Prior to forwarding the questionnaire, the offeror shall complete Section A (Contractor Information).

Offerors are responsible for ensuring that their reference sources receive the questionnaires in time to complete and return the questionnaire to the 65th Contracting Flight prior to the proposal due date.

SECTION A: Contractor Information (to be completed by the contractor (offeror) prior to mailing)

a. Contractor's name and address:

b. Point of Contact:

c. Phone No:

d. Contract Number: _________________________ Contract Type:

e. Project Title:

f. Brief Description of Service Provided: ___________________________________________

g. Period of Performance (include start & end dates):

h. Authorization is hereby granted to provide the information in SECTION B of this Questionnaire.

Signature of Offeror or Authorized Representative Date

Printed Name & Title

SECTION B: RESPONDENT INFORMATION

(To be completed by Past/Present Performance & Work Experience Evaluation respondents)

a. Respondent's address:

b. Respondent's Name:

c. Phone No: _______________ Fax: _________________ Email

d. Contract Number: ________________________ Contract Type:

e. Award Amount: _________________________ Final Amount:

f. Project Title:

g. Period of Performance (Include start & end dates) :

Filled questionnaire may be mailed to the address below or e-mail to rose.oliveira.pt@us.af.mil and taylor.haile@us.af.mil Mailing address:

65th Contracting Flight

Attn: Rose Oliveira

Bldg. T-615, Rm. 203

Avenida do Imperio, Base das Lajes 9760-227 If you have any questions regarding this questionnaire, call Rose Oliveira via telephone (011-351-295-573104) Performance Evaluation Instructions: When responding to the descriptive statements, select the letter, which most accurately describes the contractor's performance or situation. If the contractor has no record of past/present performance or work experience relevant to a particular question, select "Neutral".

(see FAR 15.305 (a)(2)(iii) and (iv))

Evaluation of the Contractor's Performance:

I.

Management/Personnel

1.

Provided experienced managers and supervisors

E V S N M U with the technical and administrative abilities to meet contract requirements

2.

Demonstrated ability to hire, maintain, and replace, if E V S N necessary, qualified personnel during the contract period

3.

All personnel were adequately trained

E V S N M U

4.

Required employee certifications were kept up to date

E V S N M U

5.

Delegated authority to project managers and supervisors E V S N commensurate with contract requirements

6.

Provided adequate supervision

E V S N M U

Management/Personnel Overall Performance Rating:

E V S N M U

Respondent’s Comments (please provide comments to support rating above) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

II.

Quality Control

1.

Followed approved quality control plan

E V S N M U

2.

Provided effective quality control and/or inspection E V S N procedures to meet contract requirments

3.

Corrected defiencies in a timely manner and pursuant to the E V S N quality control procedures.

4.

Provided timely resolution of contract discrepancies

E V S N M U

5.

Identified risks/problems as they occured

E V S N M U

6.

Displayed initiative to solve problems

E V S N M

Quality Control Overall Performance Rating:

S N M U Respondent’s Comments (please provide comments to support rating above) __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

III.

Pricing

1. Contractor provided current, accurate, and complete

V S N M U proposals.

2. Contractor provided current, accurate, and complete

E V S N M U billings.

3. Were there any contract changes, modifications, or terminations E V S N M U made due to the contractor’s failure to accurately estimate cost

4. The contractor’s supporting price/cost information for any

E V S N M U modification was accurate, complete and reasonable (not over inflated or under estimated)

Pricing Overall Performance Rating:

S N

Respondent’s Comments (please provide comments to support rating above) __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

IV. Quality Of Product

1. Met established schedules

V S N M

2. Work met or exceeded acceptable levels

S N M U

3. Service was performed in accordance with the contract

S N M U

4. Were there any known safety problems experienced

E V S N M U because of improper plant operations

5. Were there any known environmental problems E V S N M U experienced because of improper plant operations

Quality Of Product overall performance rating:

E V S N M U

Respondent’s Comments (please provide comments to support rating above) _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Other Considerations:

1. Contractor used care in treatment of furnished

YES

NO

property or other items provided to the contractor

2. Were cure notices, termination of a contract issued?

YES

NO

(If "Yes", please briefly explain circumstatnces in comments section below)

3. Would you award another contract to this contractor

(If “No”, please explain below)

Exceptional Very Good Satisfactory Neutral Marginal Unsatifactory

Overall Rating

Contractor Performance

Respondent’s Signature:__________________________________________

Date:_____________________

For Official Use Only