Attach. 4 - Past Performance Questionnaire (REV 1).pdf
PDF 1 MB Posted
- Attached to
- Recycling Services
- Solicitation number
- FA462026QA271
About this file
This is a Past Performance Questionnaire used to evaluate contractor performance for Recycling Services at Fairchild Air Force Base, Washington. The questionnaire is associated with Solicitation No. FA462026QA271 Amendment 3 and is issued by the 92 CONS/PKA contracting office.
Respondents are requested to complete the questionnaire and submit it by 24 June 2026 at 10:00 AM Pacific Time to SrA Chase Polit (Contract Specialist) at chase.polit@us.af.mil or Ms. Kathleen Rauch (Contract Officer) at kathleen.rauch@us.af.mil. Submissions may also be mailed to 92 CONS/PKA, 110 W. Ent St, Bldg. 2451, Suite 200, Fairchild AFB, WA 99011. The questionnaire requests information about the contractor being evaluated, including contractor name, address, point of contact, phone number, contract number, project title, and period of performance. It then solicits evaluations across ten performance areas using a 5-point rating scale (1=Unsatisfactory to 5=Exceptional): contract personnel performance, facility cleanliness and safety, timeline compliance, employee knowledge and experience, deficiency correction procedures, responsiveness to contract changes, professional business relationships, competitive pricing on repair items, and overall performance. Additional yes/no questions address licensing and certifications, Contract Discrepancy Reports (CDRs), cure or show cause notices, and willingness to award future contracts. Comments and remarks sections are required for any ratings below satisfactory.
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PRESENT/PAST PERFORMANCE QUESTIONNAIRE
RECYCLING SERVICES
FAIRCHILD AFB, WA
SOLICITATION NO: FA462026QA271 Amendment 3
1. Your assistance is respectfully requested in providing information on the below present/past performance questionnaire. The importance of your opinion cannot be overstated since this survey will measure the present/past performance of each prospective offeror for providing Recycling Services at Fairchild AFB, WA.
2. INSTRUCTIONS FORM COMPLETION: Please complete this questionnaire either by hand or electronically and email the results to SrA Chase Polit (Contract Specialist), at chase.polit@us.af.mil and Ms. Kathleen Rauch (Contract Officer) at kathleen.rauch@us.af.mil. Email submissions are preferred but can also be returned by mail to the following address:
92 CONS/PKA
Attn: SrA Chase Polit or Ms. Kathleen Rauch 110 W. Ent St Bldg. 2451, Suite 200 Fairchild AFB WA 99011
3. Please direct questions to SrA Chase Polit (Contract Specialist), at chase.polit@us.af.mil or 509- 247- 3488 and Ms. Kathleen Rauch (Contract Officer) at kathleen.rauch@us.af.mil or 509-247-4865.
Your Participation is greatly appreciated.
4. PLEASE RETURN NO LATER THAN: 16 June 2026 24 June 2026, at 10:00 AM (Pacific Time)
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:
FA462026QA271 Amendment 0003 Attach. 4 - Past Perfomance Questionnaire https://usaf-my.dps.mil/personal/kathleen_rauch_us_af_mil/Documents/Desktop/chase.polit@us.af.mil https://usaf-my.dps.mil/personal/kathleen_rauch_us_af_mil/Documents/Desktop/kathleen.rauch@us.af.mil https://usaf-my.dps.mil/personal/kathleen_rauch_us_af_mil/Documents/Desktop/chase.polit@us.af.mil https://usaf-my.dps.mil/personal/kathleen_rauch_us_af_mil/Documents/Desktop/kathleen.rauch@us.af.mil
c. Signature:
d. Commercial Phone #: DSN Phone #:
Fax #: E-Mail:
e. Contract Type (i.e.: Firm Fixed Price):
f. Award Amount: $ Final Amount: $
g. What was the job title for this project?
What were the scope and major functions performed under this contract?
For any ratings less than satisfactory rating, please provide explanation in Remarks section below.
1 2 3 4 5 Unsatisfactory Marginal Satisfactory Very
Good Exceptional
Performance does not Performance does not meet Performance meets Performance meets The Contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit.
The contractual performance was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective.
meet most contractual some contractual contractual contractual requirements requirements and requirements. The requirements. The and exceeds some to the recovery is not likely in contractual performance of contractual performance Government’s benefit.
a timely manner. The the element or sub-element of the element or sub- The contractual contractual performance being evaluated reflects a element contains some performance of the of the element or sub- serious problem for which minor problems for element or sub-element element contains a the contractor has not yet which corrective actions being evaluated was serious problem(s) for identified corrective actions. taken by the contractor accomplished with some which the contractor’s The contractor’s proposed appear or were minor problems for corrective actions actions appear only satisfactory which corrective actions appear or were marginally effective or were taken by the contractor ineffective. not fully implemented. was effective.
CONTRACTOR PRESENT/PAST PERFORMANCE EVALUATION
1. How well did contract personnel perform assigned duties?
5. 4. 3. 2. 1.
COMMENTS/REMARKS:
FA462026QA271 Amendment 0003 Attach. 4 - Past Perfomance Questionnaire
2. How well did contractor maintain cleanliness and safety in and around facilities in which they worked?
3. How well did the contractor meet timelines?
4. Were the contract employees knowledgeable and experienced in their position?
5. How well did the contractor correct deficiencies and valid customer complaints in a timely manner and pursuant to their quality control procedures?
6. Was the contractor responsive to contract changes?
7. How effective was the contractor in maintaining professional business relationships with customers and in resolving contract issues?
8. Did the contractor offer competitive pricing on repair items?
9. How would you rate the contractor's overall performance?
10. Did contract personnel possess all required licensing and certifications prior to start date?
Yes/No
11. Were Contract Discrepancy Reports (CDR) issued, Yes/No
Were they addressed appropriately? Yes/No If so, how?
12. Was the contractor ever issued a cure or show cause notice under the referenced contract?
Yes/No
13. Would you award another contract to this contractor? Yes/No Please explain in "remarks”.
REMARKS:
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