Atch 3 Past Performance Questionnaire.docx

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

SUBJECT: Request for Past Performance Evaluation

TO:

You have been identified as a point of contact for a past and/or present performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for a CONR/1 AF AFNORTH Manpower Support contract at Tyndall AFB, FL.

Your prompt attention to this questionnaire by no later than 4 June 2012 will be greatly appreciated. If you have any questions concerning this request, please contact Ms. Bobbie Davis via telephone at (850) 283-8665, e-mail at bobbie.davis@tyndall.af.mil or myself via telephone at (850) 283-8656, or e-mail at norma.myers@tyndall.af.mil.

Contracting Officer

Attachment Past and Present Performance Questionnaire

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104

I. CONTRACT IDENTIFICATION

A. Contractor (Company/Division):

B. Cage Code:

C. Contract Number:

D. Contract Cost:

E. Contract Type (e.g., FFP, FPIF, CPIF, CPFF):

F. Program Title:

G. Period of Performance:

H. Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

I. Brief Program Description:

II. RESPONDENT(S) TO QUESTIONNAIRE

A. Name(s):

B. Agency Name & Address:

C. Position (e.g., Program Manager, PCO/ACO):

D. Amount of time associated with the contract:

E. Phone Number(s) & E-mail:

F. Other suggested points of contact:

III. PERFORMANCE EVALUATION

Please indicate your performance rating for the contractor by placing an “X” or circling your response in the appropriate box using the performance evaluation scale below. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

CONTRACTOR’S NAME: ____________________ CONTRACT NUMBER: ___________________

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

YES/NO

CONTRACTOR’S NAME: ______________________ CONTRACT NUMBER __________________

SUMMARY QUESTIONS:

In your assessment, what, if any, would you consider the contractor’s strong points and what did you prefer the most about their performance:

Remarks:

In your assessment, what, if any, would you consider the contractor’s weak points and what did you prefer least about their performance:

Remarks:

IV. GENERAL COMMENT (Choose one of the following and explain your choice in the remarks)

Given what I know today about the contractor’s ability to execute what he promised in his proposal, I definitely would _____ probably would _____ might or might not _____ probably would not _____ definitely would not _____ award to him today given that I had a choice.

Remarks:

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

FAX COMPLETED SURVEY FORM TO: (850) 283-8491 ATTN: Ms. Bobbie Davis__ E-MAIL TO: bobbie.davis@tyndall.af.mil

CONTRACTOR’S NAME: ______________________ CONTRACT NUMBER __________________