Atch 4 Past Performance Questionnaire_V2.docx
DOCX document 43 KB Posted
- Attached to
- Flooring and Carpet Services
- Solicitation number
- FA462526Q1067
About this file
This is a Past Performance Questionnaire used by the 509th Contracting Squadron of the Air Force Global Strike Command to evaluate contractor qualifications for Solicitation FA462526Q1067, a competitive procurement for Carpet and Tile Flooring services at Whiteman Air Force Base. The questionnaire serves as source selection information and must be completed by organizations with direct experience working with prospective contractors. Responses are due by August 14, 2026, and should be submitted electronically to eliezer.resto_davila@us.af.mil and amanda.fragoso@us.af.mil.
The questionnaire requests detailed contract performance information including contractor identification, contract number, contract type, period of performance, dollar value, and scope of work performed. Respondents must rate contractor performance across 16 evaluation criteria using a five-point scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or Not Applicable), covering areas such as professional relationships, management capability, record-keeping, safety and timeliness, problem identification, subcontractor oversight, deficiency correction, employee and supplier payments, waste management, OSHA compliance, cost-effective solutions, overall performance, cure notices, hands-on flooring installation experience, and likelihood of future contract award. The underlying procurement is a single-award IDIQ contract with a base year plus four option years (October 1, 2026 through September 30, 2031), set-aside for small business concerns, with a guaranteed minimum of $500.00 and a maximum aggregate value of $500,000.00.
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Other files
| File | Type | Posted |
|---|---|---|
| COMBO_26Q1067 Revised 17Aug2026.pdf | ||
| Atch 1 SOW - Flooring Revised 12Aug2026.pdf | ||
| Atch 2 FY26 Flooring Bid Schedule_V4.xlsx | XLSX spreadsheet | |
| Atch 2 FY26 Flooring Bid Schedule_V3.xlsx | XLSX spreadsheet | |
| Atch 6 QA Solicitation FA462526Q1067.pdf | ||
| Atch 2 FY26 Flooring Bid Schedule_V2.xlsx | XLSX spreadsheet | |
| Atch 3 Wage Determination_CAO 20260513.pdf | ||
| Atch 4 Past Performance Questionnaire.docx | DOCX document | |
| Atch 2 FY26 Flooring Bid Schedule.xlsx | XLSX spreadsheet | |
| Atch 1 SOW - Flooring Requirements - July 2026.pdf | ||
| COMBO_26Q1067.pdf | ||
| Atch 5-Provisions and Clauses.pdf |
Show all 12
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Text version
When completed, this document is Source Selection Information IAW RFO 2.101 and 3.104.
FA462526Q1067, Attachment 4
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 Aug 14, 2026. 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 eliezer.resto_davila@us.af.mil and amanda.fragoso@us.af.mil. Please call SSgt Resto Dávila at 660-687-2911 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
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.): |
| Click or tap here to enter text. |
| D. Project Title: |
| Click or tap here to enter text. |
| 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: |
| Click or tap to enter a date. |
| 2. Actual Completion Date: |
| Click or tap to enter a date. |
| 3. Reason for difference (if applicable): |
| Click or tap to enter a date. |
| 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.
I. Was this a competitively awarded contract?
| J. Contractor’s Role: |
| ☐Yes ☐ No |
☐ 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): |
| Click or tap here to enter text. |
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 managers and supervisors with the technical and administrative abilities needed to meet contract requirements.
3. Kept/Provided a full and comprehensive record of all required actions, as required by the terms of the contract.
4. Demonstrated the ability to complete work in a safe and timely manner.
5. Promptly identified problems, hazardous material, or other site issues to the Agency.
6. Maintained adequate oversight of subcontractor personnel and of work performed.
7. Corrected deficiencies in timely manner and corrective action was effective.
8. Worked diligently to complete the effort with no site abandonment exceeding five (5) working days.
9. Paid all employees, subcontractors, and suppliers as required by the terms of the contract.
10. Discarded all waste or hazardous material in accordance with state, federal, local, and environmental procedures/regulations.
11. Provided and used the proper personal protective equipment (PPE) for all work in accordance with OSHA regulations.
12. Partnered with the Agency to find cost effective solutions to issues encountered during the course of work.
13. How would you rate the contractor’s overall performance on this contract?
14. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.
☐ Yes ☐ No
| 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: eliezer.resto_davila@us.af.mil and amanda.fragoso@us.af.mil. (Attn: SSgt Eliezer J. Resto Dávila and Amanda Fragoso; reference the solicitation number in the email subject - FA462526Q1067)
File details come from the government source that posted it. Updated .