_3_Past_Performance_Questionnaire.doc

DEPARTMENT OF THE AIR FORCE

7th CONTRACTING SQUADRON

DYESS AIR FORCE BASE TEXAS

12 December 2014

MEMORANDUM FOR PROSPECTIVE EVALUATORS

FROM: 7 CONS/LGCA

381 THIRD ST

DYESS AFB, TX 79607-1581

SUBJECT: Solicitation FA4661-15-R-0004, Repair HVAC Bldgs 8015 & 4201, Past Performance Questionnaire

1. The 7th Contracting Squadron is conducting a proposal evaluation for subject solicitation at Dyess AFB, TX. Under the solicitation, the Air Force will perform a Lowest Price Technically Acceptable (LPTA) evaluation. The contractor listed in Section A of the attached questionnaire has identified your office as a source to evaluate the contractor’s past performance and it also authorizes release of this information to our office.

2. The individual most knowledgeable of the contractor’s day-to-day operations and overall condition of performance rendered should complete the survey. However, that individual is encouraged to supplement their own knowledge with the judgment of others in their organization.

3. Please complete the questionnaire as thoroughly as possible and providing comments wherever applicable. For any rating of N, we request you provide an explanatory narrative and attach to your response. The narratives need not be lengthy, but should be detailed and descriptive. Use separate evaluation forms for each contract/order being evaluated.

4. Your time and effort in providing this information is greatly appreciated. The requested information is critical to our evaluation. Please complete and return the completed package as quickly as possible but not later than 2:00 PM CST 21 January 2015. You may email a scanned copy to megan.vanhorn.1@us.af.mil , FAX it to (325) 696-4084, or mail it to the following address:

7th Contracting Squadron

Attn: 2Lt Megan VanHorn

381 Third Street

Dyess AFB TX 79607

5. If you have any questions, please call 2Lt Megan VanHorn at (325) 696-2288. Thank you for your cooperation and quick response to this request.

KIMBERLY B. WELCH

Infrastructure Flight Chief/

Contracting Officer SECTION A: Contractor Information (to be completed by the contractor requesting evaluation prior to mailing. NOTE: Contractor shall also include a verbatim copy of each SECTION A (completed and mailed to the proposed respondents) and corresponding respondents’ name/address in VOLUME I (Past Performance), Refer paragraph L-3) A. Contractor’s name and address:

B. Point of Contact:

C. Phone/Fax Numbers (with area code) & E-mail Address:

D. Contract number:

E. Project Title or Description of Work performed under this project:

F. Contractor’s Role (Prime, sub, designer, etc.) _______________________________________________________________________

G. Contracting or Procurement Official (Name & Contact information): ____________________________________________________

H. Contract Type: Firm-Fixed-Price Indefinite-Delivery/Indefinite Quantity Task Order Cost-Reimbursement

I. Project Award Date:

Scheduled Completion Date:

Current/Final Completion Date:

J. Project Award Amount:

Current/Final Project Amount:

K. Comments (if desired): _________________________________________________________________________________________

L. Authorization is hereby granted to provide the information requested in SECTION B of this Questionnaire.

(Signature)

(Name and Title of Authorizing Official) (Date)

SECTION B: RESPONDENT INFORMATION (to be completed by respondent.)

EVALUATED BY:

(Signature) (Date)

Address:

(Typed or Printed Name)

(Title)

Phone/Fax Numbers (with area code) & E-mail Address

NOTE: The identity of individual(s) providing reference information shall not be disclosed.

PERFORMANCE INFORMATION: Answer the following Performance with a YES (Y) or NO (N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY “N” ON A SEPARATE SHEET (Part I, Question 1).

Evaluation Areas

Agile Combat Power