Attachment 4 Past Perf Questionnaire.pdf

FA4621-20-R-0002 Attachment 4 DPM Packing and Crating Services Past and Present Performance Questionnaire McConnell AFB Kansas 29 January 2020

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive Information 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 the DPM Packing and Crating Services contract at McConnell Air Force Base, Kansas.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, I can be contacted at (316) 759-4098.

CHRISTIAN T. ATES

Contracting Officer

Attachment:

Past and Present Performance Questionnaire http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_629 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5837

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

Reference: FA4621-20-R-0002, DPM Packing and Crating Services

When Filled In This Document Is Source Selection Sensitive Information IAW FAR 2.101 and 3.104

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 _________________* ( Dollar value should include period of performance that applies to this contract, i.e 6-months, 1 year or 5 years) 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 3 years, please complete separate evaluation forms for those contracts as well.

Contractor performed as the:

Prime Contractor Sub-Contractor Key Personnel

A. RESPONDENT INFORMATION:

Name of Respondent: __________________________________ Title: _______________________________________________ Company Name/Address: _______________________________ Telephone Number: ____________________________________ Fax Number: _________________________________________ Email Address: ________________________________________

B. E-MAIL COMPLETED SURVEY FORM TO:

Contract Administrator(s) SSgt Oscar Urquidi, at oscar.urquidi@us.af.mil

And 2Lt Charles Goldstein, at charles.goldstein.1@us.af.mil Contracting Officer MSgt Christian, Ates, at christian.ates@us.af.mil mailto:oscar.urquidi@us.af.mil mailto:charles.goldstein.1@us.af.mil mailto:christian.ates@us.af.mil

C. 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 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.

Performance meets / met contractual requirements with some exceeded to 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 meets / met contractual requirements.

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

Performance does not / did not meet some contractual 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.

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

Performance was not observed or not applicable to the current effort being reported against.

CONTRACTOR’S NAME: _____________________________

CONTRACT NUMBER: _______________________________

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

The contractor: E G S M U N

1.

Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2. Provided adequate project supervision.

3.

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

The contractor: E G S M U N

4. Home office participated in solving significant local problems.

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

6. Corrected deficiencies in a 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 project schedules.

11. Was responsive to contract changes.

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

13. Complied with all USAF regulations.

14. Cooperated with Government personnel after award.

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” section.

YES / NO

FA4621-20-R-0002 Attachment 4 DPM Packing and Crating Services Past and Present Performance Questionnaire McConnell AFB Kansas 29 January 2020

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

18. Is the contractor rated in CPARS?

19. Did this project include work on a military installation?

20. Did the Contractor stayed within the budget of the contract?

WORK PERFORMANCE QUESTIONS:

1. Did the Contractor have a local warehouse? _____________________________________

2. How was the Contractor’s performance on packing and crating services? ______________

3. Did the contractor perform a premove survey prior to performing the service? If so, was a written estimate completed prior? ________________________________________________

4. Was an inventory of the items conducted and documented?__________________________

5. Did the contractor weigh each shipment?_________________________________________

6. Does your contract include monthly, quarterly, or yearly inspections? How were these inspections documented? ________________________________________________________

7. Did the Contractor receive any successful claims? If so, how many during this current contract period? ________________________________________________________________

REMARKS: ________________________________________________________________

Signature of Reviewer Date