Atch_5_-_PPQ_Refuse.pdf

Attachment5

FA5000‐17‐R‐0006

PastPerformanceCoverLetter/Questionnaire

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATIONIAW FAR

2.101 AND 3.104

FA5000-17-R-0006

SUBJECT: Request for Past Performance Evaluation

TO:

is currently participating as an offeror in response to the Government’s Request for Quotation No. FA5000-17-R-0006 for a firm fixed price Refuse 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.

As one of our customers for past contracting work on , we are requesting that you complete the attached questionnaire regarding our past performance. This letter also authorizes you to discuss our past performance with the government and to release information regarding our past performance to the government.

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 the deadline for receipt of quotations at 10:00 A.M. ADST on Monday, 26 April 2017.

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

- Mailed to:

673dContractingSquadron Attn: Mr. Nicholas Tapp 10480 Sijan Ave Ste 363

JBER, AK 99506

- Or by email to:

nicholas.tapp@us.af.mil, nicholas.parsons.2@us.af.mil & 673CONS.LGCB.Acquisition@us.af.mil

Thank you for your assistance.

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

Attachment:PastPerformanceQuestionnaire

PASTANDPRESENTPERFORMANCEQUESTIONNAIRE

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)

CONTRACTOR COMPANY NAME: ADDRESS: CAGE CODE:

DUNS NUMBER:

POINT OF CONTACT: TELEPHONE NUMBER: FAX NUMBER:

CONTRACT NUMBER: CONTRACT TITLE:

SECTION B - RESPONDENT INFORMATION: To be completed by each reference providing information in Sections C & E.

This is a 3-page questionnaire---please complete all 3 pages.

TYPED/PRINTED NAME: TITLE: COMPANY/ORGANIZATION:

ADDRESS (Street, City, State, and Zip Code): TELEPHONE NUMBER (to include area code):

FAX NUMBER (to include area code):

E-MAIL ADDRESS: SIGNATAURE: DATE:

RETURN COMPLETED QUESTIONNAIRE TO THE INDIVIDUALS LISTED BELOW:

POINT OF CONTACT AND E-MAIL ADDRESS:

Nicholas D. Tapp -- nicholas.tapp@us.af.mil SrA Nicholas Parsons—nicholas.parsons.2@us.af.mil

MAILING ADDRESS:

673 CONS/LGCB

10480 Sijan Ave, Ste 363

JBER, AK 99506

TELEPHONE

NUMBERS

VOICE:

(907) 552-5870 or

(907) 552-7563

COMPLETE & RETURN PRIOR TO

26 April 2017 at 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.

CONTRACT NUMBER CONTRACT TYPE (Firm- Fixed Price, Cost Reimbursement, etc.):

PERIOD OF

PERFORMANCE:

COMPETITIVE CONTRACT?

YES NO

INITIAL CONTRACT VALUE: CURRENT/FINAL CONTRACT

VALUE:

TOTAL REFUSE VALUE

CONTRACT TITLE: CONTRACT BEING EVALUATED AS (indicate which):

PRIME CONTRACTOR SUBCONTRACTOR

BRIEF DESCRIPTION OF SERVICES:

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

SECTION D - EVALUATION CONFIDENCE RATING SCALE:

RATING DEFINITION

S

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

SECTION E: CONTRACTOR'S PERFORMANCE RATINGS: To be completed by each reference using the rating scale in Section D, Yes/No answers, or a brief response as indicated.

RECENCY, RELEVANCY& ADMINISTRATIVEINFORMATION

QUESTIONS NO YES

1. Is your service contract for refuse collection within the last 5 years?

2. Does your refuse collection service contract do special events, on‐call service, or unscheduled pick up?

3. Does your refuse collection service contract service dumpsters from 250 or more locations?

4. Does your refuse collection service contract service dumpsters at least 3 times a week?

5. What are the distances between the farthest waste collection facilities you service to the final drop off location? (check all that applies) 0 to 5 mile 6 to 10 miles 11 to 15 miles 16 or more miles

QUALITYOF SERVICE S U

6. How would you rate the contractor's ability to maintain waste collection service outlined in your Performance Work Statement, Statement of Work, or equivalent requirements document?

7. How would you rate the contractor’s ability to proactively respond, recognize, resolve unanticipated difficulties, correct deficiencies, re‐performance, or emergencies in the manner consistent with the contract’s quality control procedure?

8. How well did the contractor provide for sufficient and qualified manpower in the performance of this contract?

9. How would you rate the contractor’s ability to remain on schedule, meet specific response times, and scheduled time frames for completion of specific tasks while still providing quality service?

OVERALL ASSESSMENT S U

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

Evaluator's Signature Date

Thank you for your prompt response and assistance!