Attachment_5_-_Past_Performance_Questionnaire_(rev._01).pdf

FA4855-17-R-0008-0002

Attachment 5

7 June 2017

PAST PERFORMANCE QUESTIONNAIRE

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

MEMORANDUM FOR:

SUBJECT: Request for Past Performance Information

FROM: 27SOCONS/LGCA

110 E. Alison Ave, Bldg. 600

Cannon AFB NM 88103

1. You have been identified as a point of contact for a past and/or present performance evaluation of the firm identified on the attached questionnaire. This firm is currently interested in providing Melrose Air Force Range Operations, Maintenance, and Support Services for Cannon Air Force Base, Request for Proposal

FA4855-17-R-0008.

2. As part of the government’s evaluation of offers to this requirement, recent and relevant past performance will be evaluated for offerors who performed the following service categories on a DoD training range:

1) Facility management and maintenance/repair (including plumbing repair, minor electronic, grounds, and general equipment maintenance)

2) Improved roads and landing areas maintenance

3) Burn Boss services

4) Ground electronic combat/electronic warfare services

5) Maintenance for all associated hardware and systems

6) OM&S for command, control, and situational awareness system (C2SA)

7) Paramedic services

8) Range Control Officer services

9) Wildland Fire Operations services

3. Please complete the attached survey questionnaire. You may email the survey to brittney.pastore.2@us.af.mil and shane.tittinger.1@us.af.mil. Documents, using an appropriate cover sheet, may be faxed to our attention at 575-784-1148.

4. Your contribution and prompt attention to this questionnaire is greatly appreciated. To be considered timely, responses MUST be received no later than 14:00 PM MST on 21 Jun 17. If you have any questions concerning this request, please contact the contract specialist at brittney.pastore.2@us.af.mil or 575-784-6073

(DSN 681-6073).

//SIGNED//

BRITTNEY PASTORE

Contract Administrator

1 Attachment Past Performance Questionnaire http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/af_afmc/far/Far02.doc#T2101 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/af_afmc/far/FAR03.DOC#b3104 mailto:shane.tittinger.1@us.af.mil

SOURCE SELECTION SENSITIVE (When completed) IAW FAR 2.101 and FAR 3.104

A. GENERAL INFORMATION:

Contractor's Name: Telephone No.:

Business Address: Fax No.:

Point of Contact:

E-mail Address:

Contract Number: Contract Value:

Contract Period or Dates of Performance Provided: __________________________________

Project Title and Brief Description of Relevant Work: _________________________________

Location(s) of Performance: _____________________________________________________

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel

B. RESPONDENT INFORMATION:

Respondent’s Name: Title:

Address:

Telephone No.:

Fax No.:

E-mail Address:

C. RETURN COMPLETED SURVEY FORM TO:

Fax: 575-784-1148 (DSN 681-1148) Attn: 27 SOCONS/LGCA Attn: Ms. Pastore / Lt Tittinger or E-mail: brittney.pastore.2@us.af.mil and shane.tittinger.1@us.af.mil mailto:shane.tittinger.1@us.af.mil

Table 1: Definitions of Ratings.

E VG S M U

Exceptional Very Good Satisfactory Marginal Unsatisfactory

Performance meets contractual requirements and exceeds many to the

Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements and exceeds some to the

Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor was 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 appear or were satisfactory.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. 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.

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, VG, S, M, and U) that most accurately describes the contractor’s performance or situation. Refer to Table 1: Definitions of Ratings.

Place an “X” in the appropriate column using the Table 1: Definitions of Ratings # The contractor… E VG S M U 1 How would you rate the contractor's overall Management?

Briefly describe rationale behind overall rating:

1.1 Provided experienced contractor manager with skilled experience and administrative abilities.

1.2 Demonstrated ability to hire, maintain, and replace qualified contract personnel.

1.3 Provided adequate supervision and personnel assignments.

1.4 Effective coordination and communication with customer(s).

1.5 Ability to smoothly and effectively transition resources and personnel while maintaining continuity of mission support during phase-in.

1.6 Adhere to proper chain of command for performance matters?

2 How would you rate the contractor's overall Technical

Performance?

Briefly describe rationale behind overall rating:

2.1 Efficiently and effectively provide Facility Management and maintenance/repair (including plumbing repair, minor electronic, grounds and general equipment maintenance) on a DoD training range.

2.2 Efficiently and effectively maintain improved roads and landing area maintenance on a DoD training range.

2.3 Efficiently and effectively provide Fire Operations Burn Boss services on a DoD training range.

2.4 Efficiently and effectively provided ground electronic combat/electronic warfare services on a DoD training range.

2.5 Efficiently and effectively provide maintenance for all associated hardware and systems on a DoD training range.

2.6 Efficiently and effectively provide OM&S for command, control, and situational awareness system (C2SA) on a DoD training range.

2.7 Efficiently and effectively provide paramedic services on a DoD training range.

2.8 Efficiently and effectively provide Range Control Officer Services on a

DoD training range.

2.9 Efficiently and effectively provide Wildland Fire Operation services on a

DoD training range.

3 How would you rate the contractor's overall Quality of Service?

Briefly describe rationale behind overall rating:

3.1 Provided effective quality control and inspection procedure to meet requirements.

3.2 Followed approved quality control plan.

3.3 Properly completed and submitted necessary documentation.

3.4 Maintained a safe working environment.

# The contractor… E VG S M U 4 How would you rate the contractor's overall Business Relations?

Briefly describe rationale behind overall rating:

4.1 Delegated authority to contract manager and supervisors commensurate with positions

4.2 Home office participated in solving significant local problems.

4.3 Cooperated with Government personnel after award.

4.4 Paid employees/subcontractors in a timely manner.

5 Was the contractor ever issued a cure or show cause notice under the referenced contract?

Y N If Yes, explain below

6 Would you award another contract to this contractor? Y N If Yes, explain below

7 Is the contractor rated in CPARS? Y N

Additional comments by Item No.: (PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U).