Attachment_4_-_Past_Performance_Questionnaire.docx
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Attachment 4 - Past Performance Questionnaire
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FOR OFFICIAL USE ONLY
Attachment 4
PAST PERFORMANCE QUESTIONNAIRE
SUBJECT: Request for Past Performance Evaluation
TO:
1. You have been identified as a point of contact for a past and/or present performance evaluation of the firm listed on the attached survey form. This firm is currently being considered for a Mess Attendant Services contract at Tyndall AFB, FL.
2. Your prompt attention to this survey will be greatly appreciated. Questionnaire’s are due back to this office no later than 10 calendar days after receipt. If you have any questions concerning this request please contact TSgt Brian E. Swanson, preferably via e-mail, at brian.swanson.3@us.af.mil or by phone at (850)-283-8617.
| JUAN R. MARTINEZ, MSgt, USAF |
| Team Lead, Base Support Flight |
Attachment 4
PAST PERFORMANCE QUESTIONNAIRE
A. GENERAL INFORMATION:
Please correct any information below known to be inaccurate.
| Contractor’s Name: | _____________________________________ | |
| Address: | _____________________________________ |
Telephone Number: _____________________________________ Fax Number: _____________________________________ Point of Contact: _____________________________________ Project Title/Brief Description of Work:
Contract Number Provided by Offeror:
Dollar Amount*: _____________________________________ Contract Period/Dates of Performance Provided by Offeror*:
*Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete a separate evaluation form for each contract.
Contractor performed as the □ Prime Contractor □ Sub-Contractor □ Key Personnel.
B. RESPONDENT INFORMATION:
Name of Respondent: ____________________________________ Title: _________________________________________________
| Address: _______________________ | Telephone Number: _____________________ | |
| _______________________ | Fax Number: __________________________ | |
| _______________________ | E-mail Address: ________________________ |
C. INSTRUCTIONS ON HOW TO FORWARD QUESTIONNAIRE:
When you have completed your portion of this questionnaire, you will then need to forward it to the 325th Contracting Squadron, attention TSgt Brian Swanson, before the Offer Due Date and Time. It is preferred that you forward this via electronic means to brian.swanson.3@us.af.mil. It is advised that you request an acknowledgement of receipt. The 325th Contracting Squadron should receive this completed questionnaire via electronic means directly from the respondent. Printed hard, typed or hand written copies will be accepted via mail to 325 CONS/LGCAB, Attn: TSgt Brian Swanson, 501 Illinois Avenue, Suite 5, Tyndall AFB, FL 32403-5526.
D. PERFORMANCE INFORMATION:
Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. Please provide a narrative explanation for any ratings of 1 or 2.
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Unsatisfactory |
| Marginal |
| Not Applicable |
| Satisfactory |
| Very Good |
| Exceptional |
| Performance did not meet most contractual requirements and recovery did not happen in a timely manner. The contractual performance of the element being assessed contained serious problems for which the contractor’s corrective actions appeared or were ineffective. |
| Performance did not meet some contractual requirements. The contractual performance of the element being assessed reflected a serious problem for which the contractor’s actions appeared only marginally effective or were not fully implemented. |
| Unable to provide a score. Performance in this area is not applicable to the effort assessed. |
| Performance met contractual requirements. The contractual performance of the element being assessed contained some minor problems for which corrective actions taken by the contractor appeared or were satisfactory. |
| Performance met contractual requirements and exceeded some requirements to the Government’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| Performance met contractual requirements to the Government’s benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
Performance Ratings – Contract Management Did the contractor provide a Project Manager authorized to make decisions on daily contract issues?
| Was the contractor effective in managing the Project Manager? |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Were invoices submitted in a timely manner? |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
Did the contractor suggest solutions to problems and/or have the initiative to implement those solutions?
Did the Project Manager respond to and solve customer complaints in a timely manner?
Were administrative reports/documents received in accordance with contract requirement?
| How did the contractor respond to emergency requirements? |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
Did the contractor provide experienced workers with the abilities needed to meet contract requirements?
Did the contractor demonstrate the ability to hire, maintain and replace, if necessary, personnel during the contract period?
Did the contractor provide timely and satisfactory responses to customer complaints?
Did the contractor cooperate when resolving problems, contractually or otherwise, attend meetings and maintain communication to assure satisfactory resolution?
Performance Ratings – Operations
| Contractor maintained and posted menu boards. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor prepared food in accordance with all applicable guidelines. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Food was served in a proper manner, efficiently and within required timelines. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor provided adequate table cleaning services. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor adhered to all food safety and sanitation requirements. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor provided cashier services within all stated requirements. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor provided adequate housekeeping/cleaning services. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor adhered to all stated waste management requirements. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor provided adequate, timely and cost effective minor/major maintenance and repair of equipment. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Contractor provided adequately trained, uniformed and professional personnel. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
Performance Ratings – Contract Management
| YES |
| NO |
| Has an election ever been made not to exercise an option due to contractor’s poor performance? |
| □ |
| □ |
| Has the contractor ever violated the Service Contract Act? |
| □ |
| □ |
| Has a contract discrepancy report, cure notice or show cause ever been issued? |
| □ |
| □ |
| Would you award another contract to this contractor? If not, please explain in “remarks.” |
| □ |
| □ |
Remarks: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Source Selection Information – See FAR 2.101 & 3.104 4
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