Attachment 4 - Past Performance Questionnaire (PPQ).pdf

Attachment 4

Past Performance Cover Letter/Questionnaire

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION

IAW FAR 2.101 AND 3.104

FA500024Q0014 Boiler/Water Heater Maintenance

SUBJECT: Request for Past Performance Questionnaire

TO: Whom It May Concern

We are currently participating in a request for the Government’s Request for Quote No.

FA500024Q0014 for a firm fixed price contract for Boiler/Water Heater Maintenance at Joint Base Elmendorf-Richardson (JBER), Alaska.

To assist the Government in its assessment of our past performance, we are required to identify previous contracts and clients who are familiar with our past performance. For the purpose of this questionnaire, past performance is defined as contracts performed and/or being performed for any customer within the last five (5) years from the issuance date of the solicitation.

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 authorizes you to discuss our past performance with the Government and to release information regarding our past performance as directed.

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’s point of contacts identified below, to arrive no later than 2:00 P.M. local Alaska Time on Monday, 12 August 2024.

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

TSgt Nicholas Cripe at nicholas.cripe@us.af.mil and Amn Jaiden Shipp at jaiden.shipp@us.af.mil.

Thank you for your assistance.

Boiler/Water Heater Maintenance Attachment 4, PPQ

FA500024Q0014

mailto:daniel.morphew@us.af.mil mailto:jaiden.shipp@us.af.mil

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

SECTION A - CONTRACTOR INFORMATION: Offerors to complete this section prior to sending this form to each reference listed on the Past and Present Performance References form (Attachment 3)

Contractor Company Name: Address: Cage Code:

UEI Number:

Point of Contact: Telephone Number: Email Address:

SECTION B - RESPONDENT INFORMATION: To be completed by each reference providing information in Sections C & E. This is a 2-page questionnaire---please complete both pages.

Name: Title: Company/Organization:

Physical Address (Street, City, State, Zip Code): Telephone Number (to include area code): Email Address:

Signature: Date:

EMAIL COMPLETED QUESTIONNAIRE TO: nicholas.cripe@us.af.mil and jaiden.shipp@us.af.mil SECTION C - CONTRACT SPECIFICS: To be completed by each reference. Some of this information is repeated 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: (Check Yes/No) YES NO

Initial Contract Value: Current/Final Contract Value: Total Value:

Contract Title: Contract being evaluated as Prime/Sub: Contractors Role:

Description of Services:

Reason for Difference Between Initial & Current/Final Contract Costs, if any exists:

Boiler/Water Heater Maintenance Attachment 4, PPQ

FA500024Q0014

mailto:daniel.morphew@us.af.mil

SECTION D - EVALUATION RATING SCALE:

RATING DEFINITION

Acceptable The offeror successfully perform the required effort.

Unacceptable The offeror unsuccessfully perform the required effort.

SECTION E: Contractors Performance Ratings:

To be completed by each reference using the rating scale in Section D, YES/NO answers, or a brief response as indicated.

SCOPE OF WORK YES NO N/A

1. Did your service contract include any temporary or portable heating capabilities in case of an unscheduled outage.

2. Did the contractor have the ability to provide satisfactory service in sub-arctic conditions?

3. Did the contractor demonstrate the ability to effectively conduct chemical and stack anaysis on boilers?

4. Did this contract contain industrial application boiler maintenance and operations?

QUALITY OF SERVICE Acceptable Unacceptable N/A

5. How would you rate the contractor's ability to provide expedient repairs?

6. How would you rate the contractor’s ability to follow and adhere to OSHA guidelines for safety and regulatory compliance?

7. How well would you rate communication and feedback conducted within the term of the contract?

8. How would you rate the contractor's ability to hire, maintain & replace if necessary qualified personnel during the contract period?

9. How would you rate the contractors ability to maintain a schedule, meet specific response times, and adjust to varying work load?

COMPLEXITY (Types)

10. Please select the types of boilers covered in your service contract?

(Select all that apply)

Steam Hydronic Condensing Multi Boiler Configuration

11. Please select the application of the types of boilers serviced under your contract? (Select all that apply)

Commercial Industrial

Remarks:

Boiler/Water Heater Maintenance Attachment 4, PPQ

FA500024Q0014