FA4861-14-R-B051_Questionaire_Attachment_2.pdf

: FA4861-14-R –B051

Attachment 2

PAST PERFORMANCE QUESTIONAIRE

The below-named contractor/offeror is being considered for award of the contract for packing and crating contract at Nellis Air Force Base, NV, 89191. A consideration in our selection process is the contractor’s history of performance of similar efforts. Please make every effort to be thorough in your answers/comments.

A. GENERAL INFORMATION

Offeror’s Name:

Address:

Telephone Number: Point of Contact:

C. CONTRACT INFORMATION

Contract Title:

Period of Performance: Contract Number:

Dollar Amount of Contract:

BRIEF DESCRIPTION OF WORK: Describe type of working being performed

FA4861-14-R-B051

D. PERFORMANCE INFORMATION

The Air Force will use your survey responses to determine a level of confidence, based on the offeror’s past performance record, concerning the offeror’s ability to successfully perform our requirement in accordance with the contract. Please assign the following performance level codes to each of the questioned areas listed below based on the contractor’s performance at your organization or installation. The confidence codes selected will indicate the degree of doubt concerning performance in each area.

RESPONDENT WILL NOT FURNISH ANY PAST PERFORMANCE INFORMATION TO OFFEROR

SUBMITTING A PROPOSAL FOR THIS SOLICITATION.

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

E

EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VG

VERY GOOD- The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or was satisfactory.

M

MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

US

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

N/A NOT APPLICABLE - Unable to provide a score.

Please provide detailed narrative comments to support your ratings. At a minimum, please discuss each response for which you indicated E (Exceptional), M (Marginal) or US (Unsatisfactory) in response to the questions below (use additional sheets, if necessary).

E. Please use the above codes and respond to the below.

1. Quality of Service: Exceptional Very Good Satisfactoty Marginal Unsatisfactory

Not Applicable

2. Cost Control: Exceptional Very Good Satisfactoty Marginal Unsatisfactory

3. Timeliness of Performance: Exceptional Very Good Satisfactoy Marginal

Unsatisfactory Not Applicable

4. Business Relations: Exceptional Very Good Satisfactoty Marginal Unsatisfactory

F. PERFORMANCE EVALUATION AREAS

1. Please use the above ratings and their assigned definitions to describe the offeror’s performance in the following areas:

2. If a government contract, did the contractor receive any Contract Discrepancy Reports, Letters of Concern, or Cure Notices?_____No________ If yes, please describe:

3. If given the opportunity, would you award another contract to this contractor?___Yes____

Please explain response below:

Signature of Respondent___________________________________ Date____________

Job Title:________________________________________________________________

Completed questionnaires can be returned via fax, email or mail to the respondent.

B. RESPONDENT INFORMATION

Name: Stephen Colton Title Contract Administrator

Organization & Address: 99th Contracting Squadron 5865 Swaab Blvd.

Nellis, AFB, NV 89191

Telephone: 702-652-5488 FAX: 702-652-9570 Email: stephen.colton@us.af.mil

Thank you for taking the time to complete this questionnaire.

LEGEND OF TERMS

OFFEROR: The contractor in which past performance is being evaluated

SOLICITATION NUMBER: The procurement document number the government uses to identify a specific Request for Proposal (RFP)

RESPONDENT: The person and/or organization evaluating past performance

CONTRACT NUMBER: If the offeror had a contract or purchase order with your company/firm, the identifying contract number associated with awarded contract/purchase order

CONTRACT TITLE: Project title of work performed

CONTRACT VALUE: Contract/purchase order total dollar value