15-R-A007 _Attachment_7 _Past_Performance_Questionnaire.pdf

Attachment 7 FA4620-15-R-A007

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 Elevator Maintenance services for 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 Zachery Ray at zachery.ray@us.af.mil. Email submissions are preferred. You can also send by mail to the address listed above. Please direct questions to SSgt Zachery Ray at (509) 247-2608. 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.

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

PLEASE RETURN NO LATER THAN: 22 June 2015 mailto:edward.campbell.2@us.af.mil mailto:zachery.ray@us.af.mil.

PRESENT / PAST PERFORMANCE

EVALUATION QUESTIONNAIRE

SOLICITATION NO: FA4620-15-R-A007 Elevator Maintenance

Section A: Contractor Information.

Contractor’s name and address:

a. Point of Contact:

b. Phone #:

c. Contract Number:

d. Project Title:

e. Period of Performance:

SECTION B: RESPONDENT INFORMATION

a. Respondent’s name and address: Organization:

Address:

City: State: Zip: _

b. Respondent’s Name and Title:

Signature:

c. Commercial Phone #: _ DSN Phone #:

Fax #: E-Mail:

d. Contract Type:

e. Award Amount: $ Final Amount: $

f. What was the job title for this position?:

g. Was the position full time on site?:

h. Did the position require clearance to work on classified networks?

i. What duties/responsibilities did this job entail?:

Please email or FAX the completed questionnaire no later than 22 June 2015 to:

92 CONS/LGCA

ATTN: SSgt Zachery Ray and Mr. Edward Campbell

EMAIL: zachery.ray@us.af.mil/edward.campbell.2@us.af.mil

FAX: (509) 247-8685

DSN FAX: 657-8685

If you have questions regarding this questionnaire, please call SSgt Ray at (509) 247-2608.

Performance Evaluation Instructions: When responding to the descriptive statements, select the number which most accurately describes the contractor’s performance or situation. If the contractor has no record of past performance relevant to a particular question, select “1” for “Unknown Confidence”.

PERFORMANCE CONFIDENCE ASSESSMENTS

Rating Description

5. SUBSTANTIAL CONFIDENCE

Based on the offeror’s performance record, the respondent has a high expectation that the offeror will successfully perform the required effort.

4. SATISFACTORY CONFIDENCE

Based on the offeror’s performance record, the respondent has an expectation that the offeror will successfully perform the required effort.

3. LIMITED CONFIDENCE

Based on the offeror’s performance record, the respondent has a low expectation that the offeror will successfully perform the required effort.

2. NO CONFIDENCE

Based on the offeror’s performance record, the respondent has no expectation that the offeror will be able to successfully perform the required effort.

1. UNKNOWN CONFIDENCE

No performance record is identifiable or the offeror’s performance record is so sparse that no confidence assessment rating can be reasonably assigned.

Evaluation of the Contractor’s Performance: For any ratings less than satisfactory confidence, please provide explanation in Remarks section below.

MANAGEMENT PERFORMANCE:

1. How well did the contractor coordinate daily work with supervisors

N/A including arrangement of back-up personnel?

2. Was the contractor responsive to changing requirements (adding equipment)?

1 2 3 4 5 N/A

3. How effective was the contractor in maintaining professional business relationships with government personnel and in resolving contract issues?

1 2 3 4 5 N/A

4. How effective was the contractor in maintaining documentation? 1 2 3 4 5 N/A

TECHNICAL PERFORMANCE

1. How was the overall appearance and professionalism of contractor

N/A personnel?

2. Did the company respond to unscheduled service calls in a timely manner?

1 2 3 4 5 N/A

3. How well did the contractor perform routine maintenance? 1 2 3 4 5 N/A

4. Did contractor personnel possess all the required training and certificates?

1 2 3 4 5 N/A

5. Was the contractor knowledgeable and experienced working with the installed elevators?

1 2 3 4 5 N/A

CORRECTIVE ACTION HISTORY:

1. Have there been any show cause or cure notices issued or legal actions taken? (circle one)

YES NO

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

2. If Contract Discrepancy Reports (CDR) were issued, were they addressed appropriately? If so, how? (circle one)

YES NO N/A

If yes, explain and indicate the status.

EVALUATION SUMMARY:

1. Overall evaluation of the contractor. (Circle one and explain.) 1 2 3 4 5

2. Would you enter into another contract with this contractor? (circle one)

YES NO N/A

If no, please explain.

Additional Remarks: