Attachment 5 -Past and Present Performance Questionnaire.pdf

23 CONS/Services Flight Solicitation/RFQ#: FA483025Q0027 Title: Local Telecommunication Services Moody AFB, GA

Past and Present Performance Questionnaire 1 April 2025

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 Local Telecommunication Service contract at Moody AFB, GA.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, I can be contacted at ________________________________.

Please submit completed questionnaire to the Government Contract Specialist identified on the attached questionnaire.

Contractor Signature

23 CONS/Services Flight Moody AFB, GA

Solicitation/RFQ#: FA483025Q0027 Title: Local Telecommunication Services

I. GENERAL INFORMATION: To Be Completed by the Contractor

A. Offeror Information:

Name (Company/Division):

CAGE Code: DUNS Number:

If Other than the Prime Offeror, Identify Prime Offeror:

B. Program Title:

C. Contract Specifics:

Contracting Agency or Customer:

Contract Number:

Contract Type: ______ Firm Fixed Price (FFP) Contract, ______FFP Task Order or Purchase Order, _____ Cost Reimbursable or Other Contractual Arrangement Period of Performance (include options):

Contract Dollar Value:

Has the contract been entered into the Contractor Performance Assessment Reporting System (CPARS)?

Yes or No Contract Environment: _______ Performance on an Air Force or Air Force Reserve Base, ____Performance on a DoD Installation within the United States _____ Performance at a Federal, State, County or City facility within the United States, ____ Other Performance Location.

D. Description of Contract as ___________ Prime or __________Subcontractor Indicate the type of services provided and highlight portions considered most relevant to the Base Linen Exchange acquisition.

E. Number of items cleaned: _____ , Pickup per week ____ , Delivery per week____

F. Number of building pickup/delivery locations : ____

NOTE: Buildings may only be counted once, even if they may be cleaned more than once on a weekly basis. For example, if building 595 is cleaned 3 times a week, it would still only be counted as 1 building.

II. RESPONDENT INFORMATION:

To Be Completed/Accomplished By the Respondent

Name of Respondent: _____________________ Title: ______________________ Address: ___________________________________________________________ Telephone Number: __________________________________________________ Fax Number: ________________________________________________________ Email Address: ______________________________________________________

Is the information provided by the Contractor in Section I, General Information accurate? ______ Yes ______No If not explain which information is not accurate:

C. SEND COMPLETED SURVEY FORM TO ALL THE EMAIL ADDRESS BELOW:

Lt Vivian Pham Contracting Officer: vivian.pham.3@us.af.mil mailto:mary.twitty.1@us.af.mil mailto:victor.houston.1@us.af.mil

III. PERFORMANCE INFORMATION:

To Be Completed/Accomplished By the Respondent

Choose the appropriate letter on the scale (E, G, S, M, U, N) that most accurately describes the contractor’s performance or situation or N/A if performance in this area is not applicable to the effort addressed.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

E G S M U N

Exceptional Good Satisfactory Marginal Unsatisfactory Neutral Performance meets contractual requirements and exceeded many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements and exceeded some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements.

The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Performance was not observed or not applicable to the current effort being reported against.

CONTRACTOR’S NAME: ____________________ CONTRACT #: _______________

Place an “X” in the appropriate column using the definitions matrix above.

Contractor Performance or Situation E G S M U N N/A

1. How well did the contractor implement an orderly transition from the incumbent contractor?

2. How well did the contractor comply with the

International Fabricare Institute, American Institute of Laundering, and Standard Commercial Practices?

3.

How well did the contractor attract and retain qualified and fully trained personnel within their organization to ensure contract compliance?

4. How well did the contractor manage personnel clearances in order to regularly service secured locations?

5. How well does the contractor’s stain removal treatment process meet contractual requirements?

6. How well does the contractor’s complies with vehicle interior requirements?

7. Rate contractor’s ability to deliver the correct quantities.

8. How willing was the contractor to improve and correct noncompliance issues or concerns?

9. How well did the contractor handle and remove contaminated laundry from the pickup location?

10. How well did the contractor comply with pickup and delivery schedules.

11. How well did the contractor meet the sanitation and packaging requirements. If the Contractor did not perform sanitation and packaging requirements (or equivalent), rate as N/A.

12. How well did the contractor comply with washroom testing? If the Contractor did not perform washroom testing, rate as N/A.

Contractor Performance or Situation E G S M U N N/A

13. How would you rate the overall performance of the contractor under this contract?

14. Was the contractor ever issued a default, cure or show cause notice, Notice of Violation under the referenced contract? If yes, explain outcome in “remarks.”

YES/NO

15. Would you award another contract to this contractor? If not, explain in “remarks.” YES/NO

16. If a Government Contract, is the contractor rated in CPARS? YES/NO

Remarks (provide detail regarding unfavorable ratings, especially those concerning performance at child development centers and youth centers and fitness centers):