Attch_3_Past_Performance_Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Questionnaire on Contractor’s Present and Past Performance

Request you provide the following information on the contractor’s present and past performance by placing an X in the space provided by the most appropriate response. If you wish to elaborate on your answer, please provide comments on the lines provided after each question. If more space is needed, continue your comments on a separate sheet of paper and attach it to this questionnaire prior to submittal to the 28th Contracting Squadron. You are asked to provide frank, concise comments regarding your overall assessment of the contractor’s performance on the contract identified. You are urged to supplement your own knowledge of the contractor’s performance with the judgment of others in your organization. The following definitions are applicable rating levels of the contractor’s performance on the identified program.

Performance Assessment Rating Description

Please email the completed form as soon as possible but no later than the offer due date noted in the Solicitation. Please obtain this date from your contractor. DO NOT RETURN OR EMAIL THE COMPLETED QUESTIONNAIRE BACK TO THE CONTRACTOR. Forms submitted directly from the Contractor will not be evaluated. Email completed form directly to paula.moore.3@us.af.mil and cc: christopher.meyer.31@us.af.mil. Your help and prompt response are greatly appreciated.

When filled in this document is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

Rating Description

SUBSTANTIAL

CONFIDENCE

Based on the offeror’s performance record, your company has a high expectation that the offeror will successfully perform the required effort.

SATISFACTORY

CONFIDENCE

Based on the offeror’s performance record, your company has an expectation that the offeror will successfully perform the required effort.

LIMITED CONFIDENCE

Based on the offeror’s performance record, your company has a low expectation that the offeror will successfully perform the required effort.

NO

CONFIDENCE

Based on the offeror’s performance record, your company has no expectation that the offeror will be able to successfully perform the required effort.

UNKNOWN CONFIDENCE No performance record is identifiable or the offeror’s performance record is so sparse that no confidence assessment rating can be reasonably assigned.

ATTACHMENT

SOLICITATION #

Individual’s Name, Title, and Phone Number Completing Questionnaire:

Company’s Name:

Contractor’s Name

Contract Number:

Contract Title:

Period of Performance (Including Options):

Contract Amount (Including Options):

Cost Reimbursement Other

Contract Type:

1. Rate the contractor on their ability to provide adequate manning and equipment to respond to surge requirements, contingencies, emergencies, and weather delays without falling behind the regular schedule.

Substantial Satisfactory Limited No Unknown Confidence Confidence Confidence Confidence Confidence

Comments:

SOLICITATION #

ATTACHMENT

MANAGEMENT

Firm Specify:

and CAGE Code:

QUALITY OF SERVICE

2. Rate the contractor on their ability to provide effective quality control and/or inspection procedures to meet contract requirements and their ability to take appropriate action to correct deficiencies when identified. (Does the contractor conform to the government accepted quality control plan? Does the contractor provide effective quality control and /or inspection procedures to meet contractual requirements?)

Substantial Satisfactory Limited No Unknown Confidence Confidence Confidence Confidence Confidence

Comments:

3. Rate the contractor’s ability to proactively recognize and resolve unanticipated difficulties.

(Does contractor display initiative to solve problems? Does contractor identify risks/problems as they occur?)

Substantial Satisfactory Limited No Unknown Confidence Confidence Confidence Confidence Confidence

Comments:

SOLICITATION #

Comments:

CUSTOMER SATISFACTION

5. Rate the working relationship between the contractor and your company and your designated representatives. (Includes inspection personnel)

Limited No Unknown

Substantial Satisfactory Confidence Confidence

Confidence Confidence Confidence

Comments:

6. Rate the contractor on their environmental awareness. (Includes environmental compliance and environmental initiatives, such as affirmative procurement)

Substantial Satisfactory Limited No Unknown Confidence Confidence Confidence Confidence Confidence

Comments:

SOLICITATION #

TIMELINESS OF PERFORMANCE

4. Rate the contractor on their ability to provide a sufficient number of qualified personnel to ensure all contract requirements were successfully completed in an expedient manner. (Does contractor demonstrate ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period?)

Limited No Unknown Confidence Confidence Confidence

Substantial Satisfactory Confidence Confidence

Comments:

SUMMARY

8. Would you hire this contractor again?

Highly Likely Likely Unlikely Highly Unlikely

Comments:

SOLICITATION #

7. Has the contractor ever been given a Cure Notice, Show Cause Notice, Letter of Concerns, or had payment withheld for services not rendered?

Number of Cure Notices:

Number of Show Cause Notices:

Number of Letter of Concerns:

Number of times payment withheld for services not rendered: