Atch_8-_Past_Performance_Questionnaire.docx

ATTACHMENT 8

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

1. Contractor: _____________________________________________________________________________

1. Cage Code of contractor contract was awarded to: _________________________________

1. Contract number: _______________________________________

1. Contract type:Cost-Reimbursement: CPIF---- CPAF---- Other (explain)________________________ Fixed Price: FFP----FPIF---- Other (explain) _______________________________________

1. Was this a competitive contract? Yes _____ No ____

1. Period of performance: _________________________________________________________

1. Initial contract cost: $____________________________

1. Current/final contract cost: $_______________________________

1. Contractor performed work as Prime Contractor Sub-Contractor Joint Venture. For Sub-Contractor or Joint Venture, please indicate actual dollar value of work completed $____________________________

1. Reasons for differences between initial contract cost and final contract costs: _________________________

1. Description of service provided:______________________________________________________________

* 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.

SECTION 2. CUSTOMER OR AGENCY IDENTIFICATION

1. Customer or agency name: _________________________________________________________________

1. Customer or agency description (if applicable): _______________________________________________________________

1. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3. EVALUATOR IDENTIFICATION

1. Evaluator's name: _________________________________________________________________________

1. Evaluator's title: __________________________________________________________________________

1. Evaluator's phone/fax number: ______________________________________________________________

D. E-mail Address:___________________________________________________________________

E. Number of years evaluator worked on subject contract: _____________________

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

PAST PERFORMANCE EVALUATION RATINGS

Note: In the case of an offeror without a record of relevant past performance or for whom information on past performance is not available or so sparse that no meaningful past performance rating can be reasonably assigned, the offeror may not be evaluated favorably or unfavorably on past performance (see FAR 15.305 (a)(2)(iv)). Therefore, the offeror shall be determined to have unknown past performance. In the context of acceptability/unacceptability, “unknown” shall be considered “acceptable.”

The Contractor:

Yes ______ No______

Yes ______ No______

Yes ______ No______ If yes, please explain

2. Please discuss each and every response for which you indicated Acceptable/Unacceptable in response to the questions above, use additional sheets, if necessary

3. Government Contracts Only: Has/was this contract been 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, etc).

SECTION 5: NARRATIVE SUMMARY

What were the contractor’s most positive aspects in the performance of the contract?

What were the contractor’s most negative aspect in the performance of the contract? _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

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

Evaluator’s Signature Date Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Email Address: Theresa.Bryant@us.af.mil, Paula.Owen.1@us.af.mil Or FAX to: 402-294-0430 (COMM), 271-0430 (DSN)