Atch_3_-_Past_and_Present_Questionnaire.pdf

RFQ No.: FA527019QA007 Atch 3

Past and Present Performance Questionnaire (PPQ)

26 February 2019

MEMORANDUM FOR SUGGESTED CONTRACTOR’S CUSTOMER

FROM: 18 CONS/PKA

Bldg. 99, Unit 5199 Kadena AB, Okinawa, Japan

SUBJECT: Past and Present Performance Questionnaire

FOR OFFICIAL USE ONLY UPON COMPLETED/FILLED IN

The 18 CONS/PKA of the United States Air Force, Kadena Air Base, Japan is in the process of competitively evaluation quotations for Solicitation No. FA5270-19-Q-A007, Kadena and Military Family Housing (MFH) Refuse collection, transportation and disposal services at Kadena Air Base and other military installation in Okinawa.

One of the considerations in evaluation is the verification of the quoters' past performance on contracts or other work efforts, which reflect the quoter'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 quoter, for the evaluation of the quoter's performance on those contracts or work efforts.

Our areas of interest regarding the quoter are summarized in the enclosed questionnaire. Our schedule is extremely tight and we desire your written response no later than 14 March 2019. This schedule will allow us sufficient time to analyze the data prior to award of contract.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to miyoko.hokama.jp@us.af.mil. Please call Ms. Miyoko Hokama at 098-938-1111, extension 634-4678 if you have any questions. Your completed questionnaire will become a part of the official records.

Your assistance is greatly appreciated.

在日米軍カデナ基地契約中隊では、入札案件番号 FA5270-19-Q-A007（カデナ基地とその他の米軍住宅地の一般ごみ処理業務）

の請負業者を選定するに際し、入札参加業者の「過去の業務実績」を審査しており、すでにその業者との取引のある発注者か

らの情報を必要としております。入札参加業者について、添付のアンケートにご回答お願い致します。大変恐縮ですが、回

答いただいたアンケート票を、miyoko.hokama.jp@us.af.mil までメール送信していただけますようお願い申し上げます。また、

ご質問などございましたら、担当 外間 (電話番号 098-938-1111, 内線 634-4678）までお問い合わせください。頂きましたアン

ケートは業者選定の公式書類となります。ご協力を賜りますようお願い申し上げます。

JEREMY GRIMLEY

Contracting Officer

1 Atch Past and Present Performance Questionnaire

Past and Present Performance Questionnaire (PPQ)

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

業務実績履歴調査票

26 February 2019

FROM: 18 CONS/PKA

Unit 5199, Bldg 99 Kadena AB, Okinawa, Japan

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. The names of individuals providing reference information about a quoter’s past performance shall not be disclosed.

嘉手納基地契約中隊では在日米軍の業務委託契約において応札業者の受注実績とその履行内容を落札の選定基準に加えております。つ きましては貴殿の率直で簡潔なご意見を頂きたく添付の調査票をお送りした次第です。下記の説明に最も近いと思われる評価を項目別にご 回答願います。尚、ご回答内容は一切公表いたしません。

RATING SCALE 評価の目安

(S) Satisfactory ( 満 足): 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.

契約要件は満たしている。履行中に軽微な問題が生じたが、業者の是正処置は満足であった。

(N) Neutral (どちらでもない): Did not observe performance in this area. 履行内容に該当なし。

(U) Unsatisfactory (不満): 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.

契約内容を満たしておらず、期間内に改善の見込みなし。契約した業務は完了せず、業者は是正処置を怠った。

Past and Present Performance Questionnaire (PPQ)

2. CONTRACT INFORMATION (応札する業者が記入): The below listed contractor has identified they provided or are currently providing services for your company/agency. 貴殿との委託業務は以下の通りです。

a. Reference Number 履歴番号(Circle one): No. 1 -履歴 1, No. 2 -履歴 2, No. 3 -履歴 3,

b. Contractor (Company/Agency) 契約者:

c. Contractor Address/Phone契約者の住所・電話番号:

d. Prime contractor or subcontract主契約者(元請) または 再委託契約者 (下請) (Circle one)

Prime contractor (元請), Sub contract (下請), Other (その他)

e. Title of Program/Contract 契約件名:

1) Contract Number 契約番号:

2) Period of Performance 契約期間:

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

f. Contract Value/Amount (Per Year and/or Total) 契約金額(単年度合計と総契約金額合計):

3. RESPONDENT IDENTIFICATION (回答者、評価者が記入): (This information will be kept confidential). You may be contacted for additional information pertaining to past or present performance of the contractor identified in section 1 above.

ご回答の内容は公表いたしません。審査の手続き上、再度連絡を取らせていただく場合がありますので、ご理解、ご協力お願いします。

a. Company’s Name会社名:

b. Name and Title お名前と役職:

c. Phone Number 電話番号:

E-mail Address 電子メールアドレス：

d. Address 住所:

Past and Present Performance Questionnaire (PPQ)

e. Relationship to Project 契約案件における地位：

f. Length of Involvement in Project 契約案件の担当年数:

g. Date Questionnaire Completed 回答日:

Past and Present Performance Questionnaire (PPQ)

4. QUESTIONNAIRE 調査票 (Check One いずれかに｢✔｣を付けてください)

1. (Quality of Work) Were you satisfied with the quality of service performed or items supplied?

提供されたサービスや商品の満足度はどうですか。

S N U

2. (Quality of Work) How effective did the contractor’s quality control and/or inspection procedures operate?

-品質管理と作業上の検査手順は妥当ですか。

S N U

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

-契約者の作業は迅速で予定の納期に間に合ってましたか。

S N U

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

-契約者は作業上の懸案、問題解決、苦情処理に長けていましたか。

S N U

5. (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?

-契約者の作業は関連する全ての法規や安全基準を守っていますか。

S N U

6. Overall Rating -総合評価

S N U

7. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

-これまでに業務改善命令をだしたことがありますか。もしYESの場合は下記の記入欄に詳細を

記入してください。

YES NO

8. Would you hire this contractor again? If no, why?

-需要があれば、またこの業者に依頼しますか。

YES NO

a. Additional Comments/Remarks その他:

Upon completion of this survey, please send it by email to the address shown below no later than 14 March 2019 1100hrs (Japan Standard Time).

本アンケートの回答につきましてはご記入後、第18 契約中隊/契約課、もしくは電子メールにて下記あて先に2019年3月 14日 午前11 時 までに お送り下さいますようお願い致します。

18th Contracting Squadron/PKA Attn: Miyoko Hokama Phone (DSN): 634-4678 Unit 5199 Bldg 99, Kadena AB, Okinawa Japan 904-0000 Email: miyoko.hokama.jp@us.af.mil

第18契約中隊事務所 担当：外間 美代子（ほかまみよこ） Phone (DSN): 634-4678 建物番号99番 嘉手納基地内 904-0000 Email: miyoko.hokama.jp@us.af.mil

Thank you for your cooperation. ご協力ありがとうございました。 mailto:atsuko.izumi.jp@us.af.mil mailto:miyoko.hokama.jp@us.af.mil

URATING SCALE 評価の目安