Atch 5 Past Performance Questionnaire.docx
DOCX document 52 KB Posted
- Attached to
- Whiteman AFB Lime Sludge Hauling
- Solicitation number
- FA462524Q1004
About this file
This document contains a past performance questionnaire for a contractor providing lime sludge hauling services at Whiteman Air Force Base in Missouri. The contractor will be responsible for removing a minimum of 12,000 gallons of liquid lime sludge slurry on a weekly basis from the base's Water Treatment Facility, maintaining required soil testing for land application sites, and disposing of hauled materials in accordance with state, federal, local, and environmental regulations. Responses to the questionnaire are due by January 12, 2024 to assist the 509th Contracting Squadron in evaluating offerors' past performance for this requirement. The questionnaire requests ratings and comments on the contractor's performance in areas such as maintaining productive working relationships, providing experienced personnel, completing work safely and on time, identifying and addressing issues promptly, and overall performance.
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Text version
CUI
When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.
FA462524Q1004, Attachment 5 The 509th Contracting Squadron of the Air Force Global Strike Command is in the process of competitively selecting a source for Lime Sludge Hauling on Whiteman AFB.
One of the considerations in proposal evaluation is the verification of the offerors’ past performance on contracts or other work efforts which reflect the offerors’ 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 offerors’ 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 12 January 2024. This schedule will allow us sufficient time to analyze the data prior to the start of source selection.
To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to 509CONS.PKA.Services@us.af.mil (Attn: Mrs. Molly Nussbaum). Please call Molly Nussbaum at 660-687-5461 or Tammie Clippert at 660-687-5425 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.
Tammie Clippert Contracting Officer
Attachment Past Performance Questionnaire
Controlled By: 509 Bomb Wing Controlled By: 509th Contracting Squadron CUI Category: PROCURE Distribution/Dissemination Controls: FED ONLY POC: Tammie Clippert, tammie.clippert@us.af.mil, 660-687-5425
Section 1: Contract Identification
| A. Contractor (Company/Division and CAGE Code): |
| Click or tap here to enter text. |
| B. Contract Number: |
| Click or tap here to enter text. |
| C. Contract Type (e.g., fixed price, cost reimbursable, etc.): |
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| D. Project Title: |
| Click or tap here to enter text. |
| F. Period of Performance |
| 1. Original Completion Date: |
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| 2. Actual Completion Date: |
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| 3. Reason for difference (if applicable): |
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| G. Contract Dollar Value |
| 1. Original contract dollar value: |
| $Click or tap here to enter text. |
| 2. Actual contract dollar value: |
| $Click or tap here to enter text. |
3. Reasons for difference (if applicable):
Click or tap here to enter text.
H. Description of work performed:
Type description of work here.
Relevant work is similar to: 12,000 gallons of Liquid Lime Sludge Slurry removed on a weekly basis, flexibility to remove more if sludge buildup has occurred or remove less when production is down, or softening operations are halted. Maintain all MDNR testing that is required on soil where land application occurs, while ensuring adequate acreage is utilized.
| I. Was this a competitively awarded contract? |
| ☐Yes ☐ No |
| J. Contractor’s Role: |
| ☐ Prime Contractor ☐ Subcontractor |
Section 2: Customer or Agency Identification
| A. Customer or agency name: |
| Click or tap here to enter text. |
| B. Customer or agency description (if applicable): |
| Click or tap here to enter text. |
| C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands): |
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Section 3: Respondent Identification
| A. Respondent’s name: |
| Click or tap here to enter text. |
| B. Respondent’s title: |
| Click or tap here to enter text. |
| C. Respondent’s phone/fax number/e-mail address: |
| Click or tap here to enter text. |
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. |
| The Contractor: | |
| E | |
| V | |
| S | |
| M | |
| U | |
| NA |
1. Developed and maintained a cooperative and productive professional working relationship through all phases of the contract.
Comments:
2. Provided experienced personnel with the technical and administrative abilities needed to meet contract requirements.
3. Maintained sufficient staffing and equipment to complete the work in an effective and efficient manner.
4. Kept/Provided a full and comprehensive record of all required actions, as required by the terms of the contract.
5. Demonstrated the ability to complete work in a safe and timely manner.
6. Promptly identified problems, hazardous material, or other site issues to the Agency.
7. Maintained adequate oversight of subcontractor personnel and of work performed.
8. If utilized, maintain adequate compliant acreage for land application of hauled sludge product. Ensure soil testing is compliant with Agency Permit.
9. Kept fill area free of any spilled sludge, immediately clean area if spills occur.
10. Paid all employees, subcontractors, and suppliers as required by the terms of the contract.
11. Disposal of all hauled lime sludge product IAW state, federal, local, and environmental procedures/regulations.
12. Provided and used the proper personal protective equipment (PPE) for all work in accordance with OSHA regulations.
13. Partnered with the Agency to find cost effective solutions to issues encountered during the course of work. Provided solutions up front.
14. How would you rate the contractor’s overall performance on this contract?
15. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.
☐ Yes ☐ No
16. Would you award another contract to this contractor? If not, explain.
EXPLANATION:
☐ Yes ☐ No
Additional remarks (these are important; please include comments):
[click and pick the date]
Respondent’s Signature Date
Thank you for your prompt response and assistance!
Please return this completed questionnaire to:
E-Mail to: 509CONS.PKA.Services@us.af.mil (Attn: Mrs. Molly Nussbaum) CUI Page 2 of 6
File details come from the government source that posted it. Updated .