Atch_3_PPQ_ _Cover_Ltr_2013_02_13_MC T_Final.docx

ATTACHMENT 3

FA5613-13-R-0001

QUESTIONNAIRE RESPONDENT LETTER

FROM: 700 CONS/USAFE CONS Specialized Unit 3115

APO AE 09021-3115

SUBJECT: Request for Past Performance Evaluation

TO:

1. The USAFE CONS Specialized contracting flight is in the process of conducting a source selection for USAFE Medical Coding and Training (MC&T) Services requirements. One of the considerations in proposal evaluation is the verification of the offeror’s past performance on contracts which reflect the offeror’s ability to perform. The Government depends on information received from those who have first hand information, in order to evaluate the offeror’s past performance.

2. Areas of interest in the offerors past performance are summarized in the electronic past performance questionnaire e-mailed to you by the offeror.

3. Although this questionnaire was distributed to you by the offeror/contractor, it is important you electronically complete the questionnaire and forward it directly to the Government Procuring Contracting Officer (PCO), not later than 21 Mar 2013, at the following e-mail address: justin.truitt.1@us.af.mil and benjamin.wood.8@us.af.mil. If you are unable to electronically submit the questionnaire to the e-mail address above, faxed copies will be accepted and can be sent to the attention of IM/IT PCO, Mr. Justin Truitt, FAX: 011-49-6371-9748.

4. DO NOT RETURN OR E-MAIL THE QUESTIONNAIRES BACK TO THE OFFEROR OR CONTRACTOR! Once the questionnaire is filled out, it becomes source selection sensitive and needs to be handled accordingly. If you have any concern please contact Mr. Justin Truitt at +49 (0)631-536-7123.

5. Your help is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this source selection.

Sincerely,

Atch Past and Present Performance Questionnaire

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: ____________________ Telephone Number: ____________________ Address: __________________________ Fax Number: _________________________ __________________________ Point of Contact: ______________________

Project Title and Brief Description of Work: _____________________________________*

Contract Number Provided by Offeror: ___________________ Dollar Amount: ________*

Contract Period or Dates of Performance Provided by Offeror: ______________________* Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ____________________________

C. EMAIL or FAX COMPLETED SURVEY FORM TO: Mr. Justin Truitt, FAX: 011-49-6371-9748

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (A, U and UNK) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF U.

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

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

* Please explain the circumstances of any “unsatisfactory” rating in the corresponding “Remarks” area of each item.

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