19Q0123_Atch_3_PPQ.pdf

For Official Use Only When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Attachment 4: Past Performance Questionnaire - FA462519Q0123

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The 442d Fighter Wing at Whiteman AFB, MO is in the process of competitively selecting a source for the purchase and installation of GPS Repeaters.

One of the considerations in proposal evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your written response no later than 20 September 2019 by 2:00 PM CST. This schedule will allow us sufficient time to analyze the data prior to the start of evaluations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out by hand or electronically and e-mailed to 509cons.sollgcb@us.af.mil or faxed to 660-687-7083 (Attention: SrA John Cone).

Please call SrA John Cone at 660-687-4007 prior to fax transmission or if you have any questions. Your completed questionnaire will become a part of the official source selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

Micheal Fisk Contracting Officer

1 Atch Past Performance Questionnaire

FISK.MICHEAL.

D.1147356664

Digitally signed by

FISK.MICHEAL.D.114735666

Date: 2019.09.06 10:41:56 -05'00'

Attachment 4: Past Performance Questionnaire - FA462519Q0123

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Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

1. Original Schedule:

Beginning Date _________ through ____________

2. Current Schedule:

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. Contract Dollar Value

J. Description of work performed:

K. Was this a competitively awarded contract? Yes ☐ No

L. Contractor’s Role: Prime Contractor Subcontractor Key Personnel

Note: If offeror holds or has held other contracts with your agency/organization in the last three (3) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

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Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone/fax number/e-mail address:

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

E. Other suggested points of contact:

Section 4: Performance Information

In the table below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

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The Contractor: E V S M U N/A

1. Provided experienced personnel with the technical and administrative abilities needed to meet contract requirements.

SUPPORTING INFORMATION:

2. Manufactured a quality end product/item

3. Followed approved quality control plan.

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

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

6. Provided timely resolution of contract discrepancies.

7. Identified problems as they occurred.

8. Suggested alternative approaches to problems.

9. Displayed initiative to solve problems.

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The Contractor: E V S M U N/A

10. Developed realistic progress schedules.

11. Met established project schedules.

12. Provided timely resolution of warranty defects.

13. Was responsive to contract changes.

14. Paid subcontractors/suppliers in a timely manner.

15. Cooperated with Government personnel after award.

16. How would you rate the contractor's overall performance on this contract?

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

If yes, explain.

EXPLANATION:

Yes

No

18. Would you award another contract to this contractor? If not, explain.

EXPLANATION:

Yes

No

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Additional remarks:

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

E-Mail to: 509cons.sollgcb@us.af.mil FAX to: 687-7083