Attachment_3_-_PP_Survey.pdf

DEPARTMENT OF THE AIR FORCE

PACIFIC AIR FORCES

11 January 2018

MEMORANDUM FOR CONTRACTING ACTIVITY

FROM: 374 CONS/LGCB

Unit 5228, Bldg. 620, Yokota Air Base Fussa-shi, Tokyo, Japan

SUBJECT: Present/Past Performance Questionnaire

FOR OFFICIAL USE ONLY

The 374 CONS/LGCB of the United States Air Force, Yokota AB, Japan is in the process of competitively selecting a source for Japan-wide Nursing Services for Kadena, Misawa, and Yokota Air Force Base.

One of the considerations in proposal evaluation is the verification of the offerors' present/past performance on contracts or other work efforts, which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. Our schedule is extremely tight and we desire your written response no later than (5 March 2018). This schedule will allow us sufficient time to analyze the data prior to the start of negotiations. Your completed questionnaire will become a part of the official Source Selection records.

Present/Past Performance Questionnaires (PPQs) shall be sent directly to this office marked to the attention of Mr. Yuki Watabe as primary and Ms. Namiko Kaneko as alternate via e-mail to yuki.watabe.jp@us.af.mil as primary and namiko.kaneko.jp@us.af.mil as alternate, or mailed to the following address:

374th Contracting Squadron Attn: Mr. Yuki Watabe Unit 5228, Building 620 Yokota Air Base Fussa-shi, Tokyo 197-0001

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

BRIAN J. MENTEL

Contracting Officer

Attachment :

Present/Past Performance Questionnaire

Solicitation No. FA520918R0005 Attachment 3 - Present/Past Performance Questionnaires (PPQs)

Attachment 3 - Past Performance Survey Solicitation No. FA520918R0005

FOR OFFICIAL USE ONLY

PRESENT/PAST PERFORMANCE SURVEY

Date:

FROM: 374 CONS/LGCB

Unit 5228, Bldg. 620 Yokota Air Base Fussa-shi Tokyo 197-0001

1. INSTRUCTION: The contractor, who sent this survey, has provided the following project as a reference for their present/past performance. Please provide frank, concise comments regarding your assessment of the contractor’s performance regarding this project. When responding to the descriptive statements, choose the rating that most accurately describes the contractor’s performance or situation. The ratings correspond with the following descriptive values. In accordance with FAR 15.306(e)(4), the names of individuals providing reference information about an offeror’s past performance shall not be disclosed.

RATING SCALE

(E)xceptional : Performance meets contractual requirements and exceeds many to the customer’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

(V)ery (G)ood : Performance meets contractual requirements and exceeds some to the customer’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

(S)atisfactory: Performance meets contractual requirements. The contractual performance of the element or sub-element being assessed contains some minor problems for which corrective actions taken by the contractor were satisfactory.

(N)eutral : Did not observe performance in this area.

(M)arginal： Performance does not meet some contractual requirements. The contractual performance of the element or sub-element reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

(U)nsatisfactory : Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-elements being assessed reflects a serious problem for which corrective actions were not accomplished. The contractor did not take any corrective actions.

2. CONTRACT INFORMATION: The below listed contractor has identified they provided or are currently providing services for your company/agency.

a. Contractor (Company/Agency) :

b. Contractor Address/Phone:

c. Prime contractor or subcontract

d. Title of Program/Contract:

FOR OFFICIAL USE ONLY

1) Contract Number:

2) Period of Performance :

3) Services Provided (explain in detail the type of services provided by the contractor):

e. Total Contract Amount:

3. RESPONDENT IDENTIFICATION: (This information will be kept confidential in accordance with FAR 15.306(e)(4). You may be contacted for additional information pertaining to past or present performance of the contractor identified in section 1 above.

a. Company’s Name:

b. Name and Title:

c. Phone Number : _______________ FAX : ______________ E-mail Address : ＿＿＿＿＿＿＿＿＿＿＿

d. Address: _________________________________________

e. Relationship to Project : ________________________________________________

f. Length of Involvement in Project : ______________

g. Date Questionnaire Completed : ___________

FOR OFFICIAL USE ONLY

4. QUESTIONNAIRE (Circle One)

a. (Quality of Work) Were you satisfied with the quality of service performed or items supplied? E VG S N M U

b. (Quality of Work) How effective did the contractor’s quality control and/ E VG S N M U or inspection procedures operate?

c. (Timely Performance/Schedule) Did the contractor provide timely response to any inquiries/requests to perform the best service?

E VG S N M U

d. (Timely Performance/Schedule) Did the contractor provide the required service in a timely manner and on schedule?

E VG S N M U

e. (Management Effectiveness) How did the contractor maintain/manage contractor personnel training records?

E VG S N M U

f. (Effectiveness of Management for Resolution of Issues, Problems, and Customer Complaints) How well did the contractor resolve Issues/ Problems/Customer Complaints?

E VG S N M U

g. (Compliance with the Applicable Rules, Regs, Laws, including Safety Standards) How efficient was the contractor in abiding by all Rules, Regs, Laws, and Safety Standards?

E VG S N M U

FOR OFFICIAL USE ONLY

h. Would you hire this contractor again? If no, why? YES NO

i. Overall Rating: E VG S N M U

j. Additional Comments/Remarks:

Please fax or e-mail completed questionnaires to the address shown below:

Address:

374 CONS/LGCB

Unit 5228, Bldg. 620 Yokota Air Base Fussa-shi Tokyo 197-0001

Attn: YUKI WATABE Fax: 011-8142-530-7538 Phone: 011-8142-552-3014 E-mail: yuki.watabe.jp@us.af.mil

Thank you very much for your cooperation.