Attach_4_Past_Performance_Questionnaire.pdf

FA4620-14-Q-A011

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

TO:

RETURN TO: 92 CONS/LGCA

Contracting Officer 110 W. Ent St Fairchild AFB WA 99011

SUBJECT: Present/Past Performance: Contract # ________________________, Contractor: _____________________________

1. Your assistance is respectfully requested in providing information on the attached performance questionnaire. The importance of your opinion cannot be overstated. This survey measures the present/past performance of ______________________________, a prospective offeror for providing portable toilets to Fairchild AFB.

2. INSTRUCTIONS FOR COMPLETION: Fill it in by hand or type and please email the results to the Contracting Officer, Edward C. Campbell at edward.campbell.2@us.af.mil and to the Contract Administrator, SSgt Gregory Winfrey at gregory.winfrey@us.af.mil. Email submissions are preferred. You can also send by mail to the address listed above. Please direct questions to SSgt Gregory Winfrey (509) 247-2236. Your participation is greatly appreciated.

Explanation of codes:

Code PERFORMANCE LEVEL

RATING DEFINITION

Su Substantial Confidence Based on the offeror’s recent/relevant performance record, the

Government has a high expectation that the offeror will successfully perform the required effort.

Sa Satisfactory Confidence Based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.

L Limited Confidence Based on the offeror’s recent/relevant performance record, the Government has a low expectation that the offeror will successfully perform the required effort.

N No Confidence Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.

U Unknown Confidence (Neutral)

No recent/relevant performance record is available or the offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

Please circle the appropriate letter for each item on the questionnaire and provide narrative justification.

PLEASE RETURN NO LATER THAN: 26 Aug 2014 mailto:edward.campbell.2@us.af.mil

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

I. CONTRACT INFORMATION: Complete the following information on:

a. Contractor (Company/Name/address):

b. Contract:

1. Number:

2. Period of Performance: From: To:

3. Total Contract Amount:

II. RESPONDENT IDENTIFICATION: Complete the following information on your company. You may be contacted for additional information pertaining to the past/present performance of the contractor identified in section I above. (The following information will assist in the analysis of the data. Information will be kept confidential)

a. Name:

b. Position and Title:

c. Phone Number:

d. Address:

CONTRACTOR PRESENT/PAST PERFORMANCE EVALUATION

1. Did the contractor provide experienced managers and supervisors with the abilities needed to meet contract requirements?

Su Sa L N U

COMMENTS/REMARKS:

2. Did the contractor provide portable toilets in a timely manner?

3. Did the contractor provide effective quality control and/or inspection procedures?

4. Did the contractor correct deficiencies and valid customer complaints in a timely manner and pursuant to their quality control procedures?

5. Is the contractor responsive to contract changes?

6. Did the contractor maintain cleanliness and sanitation of all portable toilets furnished?

7. Did the contractor demonstrate ability to employ, maintain, and replace, if necessary, qualified personnel during the contract period? Please explain.

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

9. Was the contractor ever issued a cure or show cause notice under the referenced contract?

Yes No

10. Would you award another contract to this contractor? If not, explain in “remarks.”

Yes No

REMARKS: