Atch 3 Past Performance Questionnaire.pdf

CUI

When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

FA462525Q0004, Attachment 3

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The 509th Contracting Squadron of the Air Force Global Strike Command is in the process of competitively selecting a source for Carpet and Tile Flooring 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 June 9, 2025. 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 chance.slaton@us.af.mil and amanda.fragoso@us.af.mil. Please call TSgt Slaton at 660-687-5462 or Amanda Fragoso at 660-687-3668 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.

Amanda Fragoso Contracting Officer

Attachement Past Performance Questionnaire

Controlled By: 509 Bomb Wing Controlled By: 509th Contracting Squadron CUI Category: PROCURE Distribution/Dissemination Controls: FED ONLY POC: Amanda Fragoso, amanda.fragoso@us.af.mil, 660-687-3668 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5836 mailto:chance.slaton@us.af.mil mailto:amanda.fragoso@us.af.mil

FA462525Q0004, Attachment 3

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Section 1: Contract Identification

A. Contractor (Company/Division and CAGE Code):

B. Contract Number:

C. Contract Type (e.g., fixed price, cost reimbursable, etc.):

D. Project Title:

E. Government Project Description:

The purpose of the Carpet and Tile Flooring IDIQ is to provide carpet and tile at Whiteman AFB. The Contractor is required to perform all work in accordance with (IAW) SOW.

The Contractor shall provide all personnel, labor, equipment, supplies, tools, materials, supervision, travel, and other items and services necessary to provide carpet and tile flooring at Whiteman Air Force Base.

F. Period of Performance

1. Original Completion Date:

2. Actual Completion Date:

3. Reason for difference (if applicable):

G. Contract Dollar Value

1. Original contract dollar value:

2. Actual contract dollar value:

3. Reasons for difference (if applicable):

H. Description of work performed:

Type description of work here.

I. Was this a competitively awarded contract?

J. Contractor’s Role: ☐Yes ☐ No

☐ Prime Contractor ☐ Subcontractor

Section 2: Customer or Agency Identification http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5836

FA462525Q0004, Attachment 3

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A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

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

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.

FA462525Q0004, Attachment 3

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The Contractor: E V S M U N A

1. Developed and maintained a cooperative and productive professional working relationship through all phases of the contract.

Comments:

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

Comments:

3. Kept/Provided a full and comprehensive record of all required actions, as required by the terms of the contract.

Comments:

4. Demonstrated the ability to complete work in a safe and timely manner.

Comments:

5. Promptly identified problems, hazardous material, or other site issues to the Agency.

Comments:

6. Maintained adequate oversight of subcontractor personnel and of work performed.

Comments:

7. Corrected deficiencies in timely manner and corrective action was effective.

Comments:

FA462525Q0004, Attachment 3

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The Contractor: E V S M U N A

8. Worked diligently to complete the effort with no site abandonment exceeding five (5) working days.

Comments:

9. Paid all employees, subcontractors, and suppliers as required by the terms of the contract.

Comments:

10. Discarded all waste or hazardous material in accordance with state, federal, local, and environmental procedures/regulations.

Comments:

11. Provided and used the proper personal protective equipment (PPE) for all work in accordance with OSHA regulations.

Comments:

12. Partnered with the Agency to find cost effective solutions to issues encountered during the course of work.

Comments:

13. How would you rate the contractor’s overall performance on this contract?

Comments:

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

Comments:

☐ Yes

☐ No

FA462525Q0004, Attachment 3

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The Contractor: E V S M U N A

15. Performed actual detailed work of installing/removing carpet/tile/vinyl flooring on a federal installation?

☐ 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: chance.slaton@us.af.mil and amanda.fragoso@us.af.mil. (Attn: TSgt Chance Slaton and Amanda Fragoso; reference the solicitation number in the email subject - FA462525Q0004) http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5836 mailto:chance.slaton@us.af.mil mailto:amanda.fragoso@us.af.mil