06_Attachment_6_-_PP_Questionnaire_Draft_v1.pdf

Attachment 6

PAST PERFORMANCE QUESTIONNAIRE

Base Telecommunciation System Services McConnell AFB Kansas

FA4621-17-R-0004

PAST PERFORMANCE QUESTIONNAIRE AND COVER LETTER

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR

3.104

SUBJECT: Request for Past Performance Evaluation

TO: ____________________

You have been identified as a point of contact for a past performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for a Base Telecommunciation System Service contract at McConnell AFB, KS.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, I can be contacted at (316) 759-4525.

KENNETH A. BUTLER

Contracting Officer

Attachment:

1. Past and Present Performance Questionnaire file:///D:/far/Far02.doc%23T2101 file:///D:/far/FAR03.DOC%23b3104 file:///D:/far/FAR03.DOC%23b3104

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: __________________________________________________________________

Address: ____________________________________________________________________________

Telephone Number: ________________________ Fax Number: _______________________________

Point of Contact: _____________________________________________________________________

Project Title or Brief Description of Work: _______________________________________________

Contract Number: _________________________ Dollar Amount: ______________per____________

Contract Period or Dates of Performance Provided by Offeror:

*Note: If offeror holds or has held other contracts with your agency/organization in the last 5 years, please complete separate evaluation forms for those contracts as well.

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

B. RESPONDENT INFORMATION:

Name of Respondent: _________________________________________________________________

Title: ______________________________________________________________________________

Address: ____________________________________________________________________________

Telephone Number:__________________________ Fax Number: ____________________________

Email Address: ______________________________________________________________________

C. EMAIL COMPLETED SURVEY FORM TO THE GOVERNMENT:

Send copies of completed surveys directly to the Government at the following email addresses:

kimberlee.lowry.2@us.af.mil christian.ates@us.af.mil

If there are any questions or comments, please contact Kimberlee Lowry at 316-759-4533 or by email at

Kimberlee.lowry.2@us.af.mil.

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A

NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

E G S M U N

Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets/met contractual requirements with many

Performance meets/met contractual requirements with some exceeded to

Performance meets/met contractual requirements. The contractual

Performance does not meet/did not meet some contractual

Performance does not meet/did not meet most contractual requirements and

Performance was not observed or not applicable to mailto:kimberlee.lowry.2@us.af.mil mailto:christian.ates@us.af.mil exceeded to the

Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

requirements.

The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

the current effort being reported against.

CONTRACTOR’S NAME: ________________________ CONTRACT N0. _____________________

Place an “X” in the appropriate column using the definitions matrix above.

The contractor: E G S M U N

1. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

2. Home office participated in solving significant local problems.

3. Provided effective quality control and/or inspection procedures to meet contract requirements.

4. Complied with all federal, state and local laws and regulations to include appropriate licensing.

5. Complied with all USAF regulations.

6. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

7. Identified problems as they occurred.

8. Suggested alternative approaches to problems.

9. Displayed initiative to solve problems.

10. Met established contract schedules.

Base Telecommunciation System Services McConnell AFB Kansas

FA4621-17-R-0004

11. Was responsive to contract changes.

12. The Contractor maintained an open line of communication so that the

Contracting Officer’s Representative (COR) and/or Contract

Administrator (CA) was apprised of technical and cost issues.

12. Provided adequate project supervision.

13. Cooperated with Government personnel after award.

14. The Contractor maintained an effective ongoing Quality Control Plan to provide for monitoring, analyzing, & improving quality contract performance.

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

16. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.” YES/NO

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

YES/NO

18. Is this contract rated in CPARS? YES/NO

Remarks (All Unsatsfactory, Marginal, or Exceptional Ratings require comments to support the rating):

Signature of Reviewer Date