Past_Performance_Questionnaire.doc

Attachment 4

Attachment 4

* PAST PERFORMANCE QUESTIONNAIRE

22 July 2013

MEMORANDUM FOR WHOM IT MAY CONCERN

FROM: 20th CONS/LGCAA

321 Cullen St.

SHAW AFB SC 29152-5105

Subject: Request for Performance Information, Solicitation # FA4803-13-R-0008, Refuse & Recycling

1. One of the integral considerations in proposal evaluations is the verification of the offeror’s past performance on contracts, which reflect the offeror’s ability to perform on the proposed effort. This effort, solicitation number FA4803-13-R-0008 is for Refuse & Recycling collection for Shaw AFB, SC. We depend upon information received from agencies such as yours, which have had first hand experience with the offeror, for the evaluation of their performance. Therefore, we request that the attached questionnaire be completed concerning the offeror’s present/past performance.

2. Our areas of interest are summarized in the enclosed questionnaire. You are urged to submit your comments on similar programs for which your activity has contracts or administers contracts with the offeror. Any additional information that you think would benefit Shaw AFB, SC in our evaluation of the offeror’s proposals would be appreciated. Please note we may contact the offeror on problem areas or concerns identified to see what corrective actions have been taken or will be taken. However, the offeror was required to provide points of conact for each reference provided to the Government, and the individual’s name completitng the questionnaire will not be disclosed to the offeror.

3. Due to time constraints, it is important that the questionnaire be completed and returned by the date proposals are due to the following address:

20th CONS/LGCAA

Attn: Stephen Sullivan

321 Cullen St.

Shaw AFB SC 29152-5105

Mark documents “SOURCE SELECTION SENSITIVE/FOR OFFICIAL USE ONLY”

Completed questionnaires may be faxed to (803) 895-5339 or DSN 965-5339, or emailed to stephen.sullivan@shaw.af.mil

4. If additional information is required, please contact, Stephen Sullivan at (803) 895-5350, or Anne Baker at (803) 895-5392.

ANNE BAKER

Contracting Officer

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NUMBER: FA4803-13-R-0008

Refuse & Recycling

1. Please complete this questionnaire. The following is an explanation of the evaluation codes: PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

CONFIDENCE

LIMITED

CONFIDENCE

CONFIDENCE

Evaluator please complete the following for contracts performed for your agency:

A. Contractor: __________________________________________________________

B. Cage Code _____________________________________________________________

C. Subcontractor:_____________________________________________________________

D. Contract number: ____________________________________________________________

E. Total annual contract dollar amount: _____________________________________________

F. Period of Performance: From: ____________________ To:___________________________

Exercised Option Periods: ______________________________________________________

G. Description of services being performed: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

1. How well did management work to resolve problems encountered throughout the performance of the contract.

CONFIDENCE

LIMITED

CONFIDENCE

CONFIDENCE

Narrative: _________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. How well did the contractor demonstrate ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: _________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Home office participate in solving significant local problems?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: _________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. Provide effective quality control and/or inspection procedures to meet contract requirements?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: _________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. If this is/was an Airforce contract, how well did the contractor comply with all USAF regulations?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: _________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

6. How effective was the contractor’s quality control program.

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: ____________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. Corrected defiencies in a timely manner and pursuant to their quality control procedures?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: ____________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

8. Based on your judgment of the contractor’s performance, would you award the contractor another contract?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: ____________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. Did management personnel have sufficient experience to accomplish the requirements of the contract?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: ____________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

10. How long was this contract successfully completed?

Narrative: ____________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

11. What size containers do the contractors use(in cubic yards)?

Narrative: ____________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12. How many dumpsters was the contractor responsible for?

Narrative: ____________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

13. Please rate the contractor’s demonstrated ability on this contract in each of the following service areas (if applicable). “Satisfactory” needs no further explanation; however, if possible, please provide a short explanatory narrative for performance deemed Unknown Confidence, Little Confidence, or No Confidence.

a. Did contractor exhibit ability to identify and correct non-compliance issues or internal concerns (i.e. management, personnel, scheduling, quality issues)?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: ____________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

b. The contractor prevents trends in unacceptable performance?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: __________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

c. During the course of the contract, was notification sent to contractor identifying unsatisfactory work:

[ ] YES

[ ] NO

Narrative: ____________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

d. Was immediate action taken by contractor to correct the situation?

[ ] YES

[ ] NO

Narrative: ____________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________________________

e. How well did contractor meet Air Force deadlines?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: ____________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

f. How well did contractor respond to contract changes?

CONFIDENCE

LIMITED

CONFIDENCE

Narrative: ____________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

11. Please check “yes” or “no” to the following question:

Has the contractor ever been given a cure notice, a show cause notice, a suspension of payment, or had a claim denied?

[ ] YES (Please explain)

[ ] NO

Narrative: ___________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

RESPONDENT(S) TO QUESTIONNAIRE

A. Name(s):

B. Phone Number(s):

C. Position/Duty Title :

Name of reviewer (print) ;_______________________________________________

Location _____________________________________________________________

Telephone Number _____________________________________________________

*Note: Will be removed at time of award.

FA4803-13-R-0008 7