Attachment 6 Present Past Questionnaire.docx

SELECTION SENSITIVE IN ACCORDANCE WITH FAR 3.104

PRESENT AND PAST PERFORMANCE QUESTIONNAIRE

The government is placing increased emphasis in its acquisitions on “past performance” as a source selection evaluation factor. The information that will be provided in this questionnaire is significantly more important than cost or price in determining a source to award a contract resulting from the solicitation.

Part I needs to be completed by the Offeror, then forwarded to its Reference in accordance with the instructions below.

Part II needs to be completed by the Reference, then forwarded to the 366th Contracting Squadron in accordance with the instructions below.

PART I. OFFEROR’S PAST OR PRESENT CONTRACT INFORMATION

Instructions on how to fill out questionnaire. First make sure the document is protected (locked). Then you can use the “Tab” key to tab through each line or you can use your mouse to click on the line you want to type in your applicable information. Do not type past the length of the line. Tab to the next appropriate line to continue. If more space is needed, then go to page 10 to continue narration. Be sure to identify your continued narration with the appropriate line number. Upon completion click “Save” to save your information.

Instructions on how to forward questionnaire. When you have completed your portion of this questionnaire, you then need to forward it to your Reference. It is preferred that you forward this via electronic means (i.e. e-mail). It is advised that you use return receipt. Be sure to attach a cover letter requesting your Reference fill out the evaluation portion and forward to the 366th Contracting Squadron on or before the offer due date and time. The 366th Contracting Squadron should receive this completed questionnaire via electronic means directly from your Reference. Printed hard, typed or hand written copies will also be accepted via mail or Fax.

1. Contractor (Name, Address, and Zip code):

1.

Contract Number:

1. Program/Project Title:

1. Type of Contract : Fixed Price |_| Cost Reimbursement |_| Other |_| (Explain)

1. Description, location, and relevancy of work:

1. Brief description of effort as Prime |_| or Subcontractor |_|.

(Please indicate whether it was development and/or production, or other acquisition phase and highlight portions considered most relevant to current acquisition).

1. Complexity of Work : Difficult |_| Routine |_|

1. Performance Period:

1. Date of Award:

1. Original Contract Dollar Value:

1. Current/Completed Contract Dollar Value:

1. If amounts for 10 and 11 above are different, provide a brief explanation.

1. Contract Completion Date (including extensions):

1. Type and Extent of Subcontracting :

1. Point of Contact Information:

1. Procuring Contracting Officer:

Name:

Address:

Telephone Number:

E-mail:

1. Administrative Contracting Officer (if applicable):

Name:

Address:

Telephone Number:

E-mail:

c. Contracting Officer’s Representative:

Name:

Address:

Telephone Number:

E-mail:

PART II. RESPONDENT/GOVERNMENT OFFICIAL’S INFORMATION AND PERFORMANCE EVALUATION

The government is placing increased emphasis in its acquisitions on “past performance” as a source selection evaluation factor. You have been provided as a reference in response to the solicitation for Simplified Acquisition of Base Engineer Requirements (SABER) at Mountain Home AFB ID. In order for the government to evaluate the past performance of the firm providing you as a reference, please complete this questionnaire and forward to the 366th Contracting Squadron in accordance with the instructions listed below.

The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable.

Instructions on how to fill out questionnaire. First make sure the document is protected (locked). Then you can use the “Tab” key to tab through each line or you can use your mouse to click on the line you want to type in your applicable information. Do not type past the length of the line. Tab to the next appropriate line to continue. For the evaluation portion it is easiest to use the mouse to point and click on the square of your choice. Choose just one square for each item. Upon completion click “Save” to save your information.

Instructions on how to forward questionnaire. When you have completed your portion of this questionnaire you then need to forward it to the 366th Contracting Squadron, attention Andrea Porter, before the proposal due date and time. It is preferred that you forward this via electronic means (i.e. e-mail). It is advised that you use return receipt. The 366th Contracting Squadron should receive this completed questionnaire via electronic means directly from the Reference. Printed hard, typed or hand written copies will also be accepted via mail or Fax.

Offer Due Date and Time: 15 July 2010, 4:30 P.M. Local Time

E-Mail to: andy.porter@mountainhome.af.mil

FAX to: 208-828-4031 or DSN 728-4031

Mail to: 366 Contracting Squadron/LGCB Attn: Andrea Porter 366 Gunfighter Avenue Suite 498 Mountain Home AFB ID 83648-5258

P.O.C.: Andrea Porter at 208-828-3113 or DSN 728-3113

1. Respondent/Government Official’s Information

Name:

Position/Title:

Address:

Telephone Number:

Fax:

E-mail:

1. Relationship and time involved with Contractor:

1. Date questionnaire was completed:

The following chart depicts the ratings that are to be used to evaluate the contractor’s performance:

For any neutral, marginal, or unsatisfactory ratings, please provide explanatory narratives in the remarks block. These narratives need not be lengthy, just detailed. If a question is not applicable, mark N/A. If more space is needed, use the back of the questionnaire or attach additional pages. If more space is needed, then go to page 10 to continue narration. Be sure to identify your continued narration with the respective line number.

Remarks:

Management Effectiveness

The following area is provided for your continued narrations if more space was needed. Be sure to identify your continued narration by its respective Part and Item number (i.e. Part I – 5: or Part II – 4a). The computer should automatically add pages if it is required as you type your narrations.