FA5613-20-Q-0009 A4 Past Performance Questionnaire.doc

FA5613-20-Q-0009

Attachment 2

PAST PERFORMANCE QUESTIONNAIRE

This Acquisition is for 86th MXG C-130 Aircraft Wash Services at Ramstein AB.

A.

GENERAL INFORMATION:

Contractor’s Name:

Address:

Telephone Number:

Email Address:

Point of Contact:

Project Title or Brief Description of Work*:

Contract Number*:

Contract Amount:

Contract Period or Dates of Performance*:

Contractor performed as the ( Prime Contractor ( Sub-Contractor ( Key Personnel.

To be completed by the respondent and returned directly to the contracting office.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 5 years, please complete separate evaluation forms for those contracts as well.

B.

RESPONDENT INFORMATION:

Primary

Alternate Name of Respondent:

Name of Respondent:

Title:

Title:

Telephone Number:

Telephone Number:

Email Address:

Email Address:

C. RETURN COMPLETED SURVEY FORM PRIOR TO OFFER DUE DATE OF 2 MARCH 2020:

Attn: 700 CONS/PKA SSgt Jessica Young jessica.young.7@us.af.mil +49-631-536-6598 or DSN 489-6598

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATING GIVEN.

Performance meets contractual requirements with many exceeded to your organization’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to your organization’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

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

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

Performance was not observed or not applicable to the current effort being reported against.

Place an “X” in the appropriate column using the definitions matrix above.

CONTRACTOR’S NAME:

CONTRACT NUMBER:

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix above.

(to include security and proper skill levels)

If yes, explain outcome in “remarks.”

YES / NO

Strengths:

Weaknesses:

Other Remarks:

CONTRACTOR’S NAME:

CONTRACT NUMBER:

For Official Use Only