Past_Performance_Questionaire.doc

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Attached to
Hospital Aseptic Management Services Federal contract opportunity
Solicitation number
FA5587-16-R-0004
Issued by
Department of the Air Force United States Air Forces in Europe - Air Forces Africa

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Past Performance Questionnaire

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DEPARTMENT OF THE AIR FORCE

48TH FIGHTER WING (USAFE)

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION

Offeror’s Name:

Telephone Number:

Address:

Point of Contact:

Project Title and Brief Description of Work: (please include scope and magnitude)______

Contract Name/Number:__________________________ $/£ Amount:______________

Contract Period: ________________________________ Contractor performed as the ( Prime Contractor ( Sub-Contractor ( Key Personnel.

B. CUSTOMER RESPONDENT INFORMATION:

Name of Respondent: _________________ Title: _____________________________ Company/Organization:_______________

Telephone Number: __________________ Address: __________________________ Email address:______________________

C. E-MAIL COMPLETED SURVEY FORM TO:

48CONS.FAST.FASTTeamOrgBox@us.af.mil.

D. PERFORMANCE INFORMATION:

Choose the appropriate evaluation of past performance information on the scale that most accurately describes the offeror’s performance or situation for your organization.

Rating
Description

VERY RELEVANT (VR)

Past/present performance effort involved essentially the same scope and magnitude of effort and complexities this solicitation requires.

RELEVANT (R)

Past/present performance effort involved similar scope and magnitude of effort and complexities this solicitation requires.

SOMEWHAT RELEVANT (SR)

Past/present performance effort involved some of the scope and magnitude of effort and complexities this solicitation requires.

NOT RELEVANT (NR)

Past/present performance effort involved little or none of the scope and magnitude of effort and complexities this solicitation requires.

Once completed this is Source Selection Information -- See FAR 2.101 and 3.104 Place an “X” in the appropriate column using the definitions matrix above.

The contractor:
A
U
N/A
1.
Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements and adequate project supervision at the place of performance.
2.
Demonstrated ability to hire, retain, and/or replace, if necessary, qualified personnel during the contract period.
3.
Passed health and sanitation inspections.
4.
Provided effective quality control and/or inspection procedures to meet contract requirements.
5.
Corrected deficiencies in timely manner and pursuant to their quality control procedures.
6.
Displayed initiative to solve problems.
7.
Performed services in a timely manner.
8.
Was responsive to contract changes.
9.
Offeror conducted effective Business relations (partnering meetings, etc).
10.
Compliance with invoicing requirements.
11.
Offeror’s staff were fully trained on the specific contract requirements.
12.
Fair and reasonable prices for quality of service rendered.
13.
Provided adequate number of personnel to carry out the requirements of the contract. (Allowing for leave of absence, etc.)
14.
Offeror’s quality control process included an effective inspection system.
15.
Offeror displayed ability to adapt to new technologies and/or equipment requirements.
16.
Offeror exhibited effective performance through subcontractor teaming arrangements.
17.
How would you rate the offeror’s overall performance?

Remarks: (may use additional pages if needed)________________________________________

**Once completed this is Source Selection Information – see FAR 2.101 and 3.104

File details come from the government source that posted it. Updated .