Attach-2_Past_and_Present_Performance_Questionaire.pdf

Four Bay Test Cell Maintenance FA5270-16-T-0031 Attachment 2

PAST AND PRESENT PERFORMANCE

QUESTIONNAIRE

FOR

SOLICITATION NO. FA5270-16-T-0031

Four Bay Test Cell Maintenance, Kadena, Okinawa, Japan

(7 Pages to include this cover page)

PAST PERFORMANCE QUESTIONAIRE

FOR

SOLICITATION NO. FA5270-16-T-0031

The government is placing increased emphasis in its acquisitions on “past performance” as an evaluation factor. You have been provided as a reference in response to the subject solicitation for Maintenance of 4 Bay Test Cell Facility, Kadena AB, Okinawa, Japan. In order for the government to evaluate the past performance of the firm providing you as a reference please provide frank, concise comments regarding your assessment of the contractor’s performance regarding this project. In accordance with FAR 15.306(e) (4), the name of individuals providing reference information about an offeror’s past performance shall not be disclosed.

Upon completion of this survey, e-mail to the address shown below no later than 4:30pm, 15 Aug 2016 (Japan Standard Time).

18th Contracting Squadron/LGCB Attn: Capt Kimberly Madorran Phone: 634-5821

Bldg. 95, Kadena AB, Okinawa E-mail address: kimberly.madorran.1@us.af.mil

The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable.

In the event of inconsistency between English language and translation thereof into Japanese language, the English language meaning shall control.

If you have any questions concerning this survey, please call Capt Kimberly Madorran at 634-5821 or send e-mail at kimberly.madorran.1@us.af.mil. Your time and effort in providing this vitally important information are greatly appreciated.

mailto:kimberly.madorran.1@us.af.mil mailto:james.molden@us.af.mil

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

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

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: _____________________________________________________________

B. Cage Code of contractor contract was awarded to: _________________________________

C. Contract number: _______________________________________

D. Contract type: ______________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance: _________________________________________________________

G. Initial contract cost: $____________________________

H. Current/final contract cost: $_______________________________

I. Reasons for differences between initial contract cost and final contract costs:

J. Description of service provided:

Did work provided require maintenance on the following: Yes No Aircraft Engine Diagnostic Facility Automated Data Acquisition System(ADAS)

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name: _________________________________________________________________＿＿＿

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name:

B. Evaluator's title:

C. Evaluator's phone/fax number: ___________________________________________________________________

Number of year’s evaluator worked on subject contract: _____________________

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

A ACCEPTABLE - The contractor’s performance meets contractual requirements and/or exceeds many

(requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

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

N NOT APPLICABLE - Unable to provide a score.

Section 4

<Quality of Work>

1. Contractor’s ability to effectively control the quality of services provided.

当該業者はサービス内容の品質管理を効果的に行う能力を有していますか。

A

U

N/A

Comments (コメント・その理由など)

2. Have you filed claims involving loss or damage?

当該業者に損害によるクレームを申し立てたことがありますか？

YES

NO

YES (はい) Rate if the Contractor demonstrated a cooperative behavior.

申し立てをされた経験が有る場合、当該業者の対応を右の５段階で評価して下さい。

If YES, records of claims? (はい)の場合、契約期間中申し立てたクレームの数は？ ( 件)

NO (いいえ) トラブルの経験無しの場合、N/A に○をつけてください。

<Timely Performance/Schedule>

3. Were there required performance time frames? What time frames were required, and did the Contractor meet them?

貴社は、発注の際、作業開始・終了時間を指定していましたか。指定していた という場

合、どのような指定時間でしたか。また、その指定時間通り にサービスは提供されました

か。

4. Contractor’s ability to meet specific response times and required time frames for providing the services.

当該業者が要求されている時間内に適切にサービスを供給できる能力を評価し てくださ

い。

5. Contractor’s responsiveness/timeliness for providing monthly reports/ documents/ submittals required by the contract.

当該業者は月例報告書や書類の提出に際して契約で要求されているとおりに 対処し、期限

も守られていますか。

<Effectiveness of Management for Resolution of Issues/Problems/Customer Complaints>

6. Does the company resolve issues, problems, customer complaints in a timely manner?

当該業者は契約や業務上の問題やクレームに対する対応を速やかに行っていま すか。

<Compliance with the Applicable Rules, Regs, Laws, including Safety Standards>

7. Contractor’s safety standards to meet the applicable Government policies, regulations, and contract requirements.

当該業者の政府の方針、規則及び契約の要求に対する安全基準の達成度について。

2. Please discuss each and every response for which you indicated as marginal or unsatisfactory in response to the questions above (use additional sheets, if necessary).

3. Government Contracts Only: Has/was this contract been 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, etc.).

SECTION 5: NARRATIVE SUMMARY

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs? Has election ever been made not to exercise a contract option or continue relations due to the contractor’s poor performance?

Overall Assessment A U N

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

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

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address: kimberly.madorran.1@us.af.mil mailto:james.molden@us.af.mil