19R0012_Atch_3_PPQ.pdf

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

52.212-1 Attachment: Past Performance Questionnaire

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The 509th Contracting Squadron of the Air Force Air Force Global Strike Command is in the process of competitively selecting a source for a Packing and Crating Service. The contractor will furnish all personnel, equipment, facilities, supplies, services and materials, for the preparation of personal property moves of DoD employees in and around the Whiteman Air Force Base community area.

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 Aug 26, 2019. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to 509cons.sollgcb@us.af.mil or by hand and faxed to 660-687-7083 (Attention: Lt Shawn Edgecomb). Please call Lt Shawn Edgecomb at 660-687-2911 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 D. FISK

Contracting Officer

1 Atch Past Performance Questionnaire

52.212-1 Attachment: Past Performance Questionnaire

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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 (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? Yes No

L. Prime Contractor Subcontractor Key Personnel

Note: If offeror holds or has held other contracts with your agency/organization in the last five (5) 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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C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. name:

B. title:

C. 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 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 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 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 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 s appear or were ineffective.

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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.

The Contractor: E V S M U N/A

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

SUPPORTING INFORMATION:

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

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

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

7. Contractor maintained DD Form 1812, Warehouse Inspection Report, with a passing score.

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The Contractor: E V S M U N/A

8.

warehouse, workmen compensation, liability and automobile.

9.

responsibilities that conflicted with performance as QC.

10. good working relationships with the Government Inspectors and the Contracting Staff

11. Contractor demonstrated adequate inspection and resolution for safety requirements.

12. How well did the contractor comply with environmental requirements?

13. How well did the contractor comply with security requirements?

14. Provided timely resolution of contract discrepancies.

15. Met established delivery schedules.

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The Contractor: E V S M U N/A

16. Was responsive to contract changes.

17. Was responsive to emergency and/or surge situations.

18. Provided adequate project supervision.

19. Paid subcontractors/suppliers in a timely manner.

20. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

21. Cooperated with Government personnel after award.

22. Met or exceeded small business and small disadvantaged business goals set forth in the approved subcontracting plan.

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

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The Contractor: E V S M U N/A

24. If the contract included FAR 52.219-9, to what degree was the contractor able to meet or exceed small business and small disadvantaged business goals set forth in the approved subcontracting plan?

(Please state if FAR 52.219-9 was not included in the contract)

25. If the contract included FAR 52.219-8, how effectively did the contractor manage small business participation to meet technical performance?

(Please state if FAR 52.219-8 was not included in the contract)

26. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.

EXPLANATION:

Yes

No

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

EXPLANATION:

Yes

No

Additional remarks:

Respondent Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

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Mailing Address:

509 CONS/PKB

660 Tenth St, Ste 222

Whiteman AFB, MO 65305

FAX to: 660-687-7083

E-Mail to: 509cons.sollgca@us.af.mil