Attachment_4_-_FA520919RA010_(PPQ).pdf

For Official Use Only When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Attachment 8 to RFP No. FA520919RA010: Past Performance Questionnaire

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The 374th Contracting Squadron of the Air Force at Yokota Air Base is in the process of competitively selecting a source for Design and Install of Energy Management Control System (EMCS) and Direct Digital Control (DDC) Panel at facilities.

One of the considerations in proposal evaluation is the verification of the offerors' 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. In order to meet the acquisition milestones, we request your written response no later than 24 JUNE 2019, 1400 hours (local time). This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed or mailed to the address specified on page 6 of this questionnaire.

Please call Mr. Yuki Watabe at 042-552-2511 ex) 5-5416 (Domestic Call)/ 011-81-425-52-2511 ex) 5-5416 (International) or e-mail yuki.watabe.jp@us.af.mil and/or Mr. Ken Sato at e-mail ken.sato.jp@us.af.mil if you have any questions.

Your completed questionnaire will become a part of the official Source Selection records.

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.

NAMIKO KANEKO

Contracting Officer

1 Atch Past Performance Questionnaire

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Section 1: Contract Identification (The offeror shall fil l this section)

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type: ☐ Firm-Fixed-Price ☐ Fixed-Price Incentive Fee ☐ Cost-Plus-Incentive-Fee

☐ Cost-Plus-Fixed-Fee ☐ Indefinite-Delivery Indefinite-Quantity ☐ Other (Explain):

E. Program / Project Title:

Type of project (Check One):

☐ SCOPE 1: Mechanical Work: Design-Build of Install EMCS system and/or DDC control devices

☐ SCOPE 2: Mechanical Work: Install EMCS system and/or DDC control devices

☐ SCOPE 3: Mechanical Work: Design-Build for HVAC project

☐ SCOPE 4: Electrical Work: Provide electrical power systems for mechanical and communication systems.

F. Brief Program / Project Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD) / Progress - % (Percent) project work performed (if applicable):

H. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. Contract Value (Insert Japanese Yen or U.S. Dollar):

1. Original maximum contract value (assuming all options exercised):

2. Current maximum contract value (assuming all options exercised):

3. Reasons for difference between original and current contract value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? ☐ Yes ☐ No

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel ☐ Joint Venture

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Section 2: Customer or Agency Identification (The offeror shall fi ll this section)

A. Contracting activity / customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract:

☐ Local ☐ Nationwide ☐ Worldwide ☐ Other Commands (Explain):

Section 3: Respondent Identification (Client shall fill this section)

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / fax number / e-mail address:

D. Respondent’s position (e.g., Program Manager, PCO/ACO, etc.):

E. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

F. Other suggested points of contact:

Section 4: Performance Information (Client shall fill this section)

In the tables below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the

Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified

For Official Use Only Page 4 of 6 corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

Quality Control E V S M U N/A

Q1. Quality of Workmanship; Adequacy of the Contractor Quality Control (CQC) Plan; Implementation of the CQC Plan; Quality of QC documentation; Adequacy of QC testing (技術や品質管理について評価をしてくだ さい)

Q2. Storage of materials (資材の管理について評価をしてください)

Q3. Adequacy of submittals; Adequacy of As-Built (竣⼯図や材料承認な

ど、提出物について評価をしてください)

Q4. Use of specified materials (指定材料の使⽤状況について評価をしてください)

Q5. Identification/correction of deficient work in a timely manner (⽋陥 品や問題点に対する解決案・解決⽅法について評価をしてください)

Timely Performance E V S M U N/A

T1. Adequacy of initial progress schedule; Adherence to approved schedule; Resolution of delays (⼯程表の遵守状況や遅延への対応について評価 をしてください)

T2. Submission of required documentation (書類回りについて評価をしてください

T3. Completion of punchlist items (軽微な修正点への対応について評価をしてくだ

さい)

T4. Warranty Response (保証期間内の対応について評価をしてください)

Effectiveness of Management E V S M U N/A

E1. Cooperation and responsiveness; Management of resources/personnel; Coordination and control of subcontractors;

Review/resolution of subcontractor’s implementation of subcontracting

For Official Use Only Page 5 of 6 plan; Effectiveness of job site supervision; Adequacy of site clean-up;

Professional conduct (現場管理について評価をしてください)

E2. Compliance with laws and regulations (規則や法律の遵守状況について評 価をしてください)

Compliance with Safety Standards E V S M U N/A

S1. Adequacy of safety plan; Implementation of safety plan; Correction of noted discrepancies (安全対策について評価をしてください）

Cost Performance E V S M U N/A

C1. How accurately did the contractor forecast contract costs?

(契約者の積算/予測した契約⾦額がいかに正確であったかを評価してください)

C2. How well did the contractor meet forecasted costs and perform within contract costs? （契約⾦額の範囲において契約内容は遵守され

たか評価してください）

C3. How successfully did the contractor alert the Government/Contracting Activity of unforeseen costs before they occurred? (不測なコストが発⽣する前にそれを⽶政府/発注者にいかに⾸尾よく知らさ れたか評価してください)

Overall E V S M U N/A

O1. How would you rate the contractor's overall performance on this contract? (この契約における契約者の総合評価をして下さい)

Please discuss each and every response for which you indicated E (exceptional), M (Marginal) or U (Unsatisfactory) in response to the questions above 9use additional sheets, if necessary)

Government Contracts Only: Was this contract partially or completely terminated for default or convenience, or are there any pending terminations?

☐ Yes ☐ Default ☐ Convenience ☐ Pending Terminations ☐ No

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules).

SECTION 5: GENERAL COMMENT

Given what I know today about the contractor’s ability to execute what he promised in his proposal, I

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[ click and select an item ] award to him today given that I had a choice.

REMARKS:

Please provide any additional comments concerning this contractor’s performance, as desired.

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address: 374th Contracting Squadron/PKBA

Attn: Mr. Yuki Watabe and Mr. Ken Sato Unit 5228, Building 620, Yokota AB Fussa-shi, Tokyo 197-0001, Japan

E-Mail to: Both Mr. Murakami yuki.watabe.jp@us.af.mil and Mr. Ken Sato ken.sato.jp@us.af.mil