Past_Performance_Questionnaire.docx

Attachment 6 Past Performance Cover Letter/Questionnaire

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 AND 3.104

FA50000-16-T-0069

SUBJECT: Request for Past Performance Evaluation TO:

is currently participating as a quoter in response to the Government’s Request for Quotation No. FA5000-16-T-0069 for a firm fixed price boiler maintenance contract at Joint Base Elmendorf-Richardson, Alaska.

The government will be selecting contractors for this project based on selection factors. One of the key factors in the government’s final decision is past performance. To assist the government in its assessment of contractor past performance, we are required to identify previous projects and clients who are familiar with our past work. For the purposes of this questionnaire, past work is defined as contracts performed and/or being performed for any customer within the last three (3) years from the issuance date of the solicitation (May 11, 2016)

Your prompt attention in completing the attached questionnaire will ensure we receive full consideration in this competition. Please return the completed form to the government representative point of contact identified below, to arrive no later than 10:00 A.M. AKST on Wednesday, May 25th, 2016.

Please use the point of contact information below to mail or email the completed questionnaire:

· Mailed to:

673d Contracting Squadron Attn: Mr. Nicholas Tapp 10480 Sijan Ave Ste 363

JBER, AK 99506

· Or by email to:

nicholas.tapp@us.af.mil & michael.williams.81@us.af.mil

Thank you for your assistance.

(Signature and title of individual having the authority to sign for and legally bind the quoter.)

Attachment: Past Performance Questionnaire

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

SECTION A - CONTRACTOR INFORMATION: Offeror is to complete this section prior to sending this form to each reference listed on the Past and Present Performance References form (Attachment 5).

SECTION B - RESPONDENT INFORMATION: To be completed by each reference providing information in Sections C, D, & E. This is a 3-page questionnaire---please complete all 3 pages.

RETURN COMPLETED QUESTIONNAIRE TO THE INDIVIDUAL LISTED BELOW:

POINT OF CONTACT AND E-MAIL ADDRESS:

Nicholas D. Tapp -- nicholas.tapp@us.af.mil Michael Williams – michael.williams.81@us.af.mil

MAILING ADDRESS:

673 CONS/LGCB

10480 Sijan Ave, Ste 363

JBER, AK 99506

TELEPHONE NUMBERS

VOICE: (907) 552-

5870 or 552-3771 COMPLETE & RETURN PRIOR TO 25 May 16, 10:00 a.m.

Alaska Daylight Standard Time (ADST)

SECTION C - CONTRACT SPECIFICS: To be completed by each reference. Some of this information is repeat from Section A and is requested only to confirm the information.

Fixed Price, Cost Reimbursement, etc.):

YES NO

PRIME CONTRACTOR SUBCONTRACTOR

CONTRACT TITLE:

BRIEF DESCRIPTION OF SERVICES:

Number of Boilers Serviced:

REASON FOR DIFFERENCE BETWEEN INITIAL AND CURRENT/FINAL CONTRACT COSTS:

SECTION D – PERFORMANCE INFORMATION: To be completed by each reference.

1. Does your contract involve maintenance and service of high efficiency condensing boilers?

2. Does your contract involve maintenance of cast iron pipe sections?

3. Does your contract involve maintaining 60 or more boilers?

SECTION E - QUALITY ASSESSMENT RATINGS: To be completed by each reference.

S

Satisfactory During the contract period, contractor performance is meeting (or met) contract requirements. For any problems encountered, contractor took effective corrective action.

U

Unsatisfactory During the contract period, contractor performance is not meeting (or did not meet) contract requirements. For any problems encountered, corrective action appeared only marginally effective, not effective, or not fully implemented. Customer involvement was required.

4. How would you rate the contractor's ability to maintain boilers and associated systems to the standards outlined in your Performance Work Statement, Statement of Work, or equivalent requirements document?

5. How well did the Contractor respond to any outages or emergencies in the boilers or associated systems?

6. How would you rate the contractor's responsiveness and timeliness in submitting deliverables and administrative documents such as rosters, maintenance schedules, plans, logs, and testing information?

MANAGEMENT

7. How would you rate the contractor's overall effectiveness in managing the contract including environmental, safety health and security requirements?

8. How would you rate the contractor’s ability to effectively manage subcontractors?

OVERALL ASSESSMENT

9. What is your overall assessment of this past performance for this contractor?

10. Would you hire this contractor again? If not, please explain.

Evaluator's Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address: nicholas.tapp@us.af.mil & michael.williams.81@us.af.mil

Source Selection Sensitive Upon Completion – See FAR 2.101 and 3.104