Attachment_3_Past_Performance_Questionnaire.pdf

Attachment 3 Contractor’s Name:_____________________ Contract Number:_________________________

PAST PERFORMANCE QUESTIONAIRE

SOLICITATION FA5613-15-R-0003

This Solicitation is for Adult and Youth Sports Officials Services for the Kaiserslautern Military Community (KMC) area to include Sembach Air Base (AB), Ramstein AB, Vogelweh Air Station (AS), Kapaun AS, and Landstuhl Army Base. The services include providing sports officials for approximately 1,648 games annually in the sports disciplines of basketball, flag football, volleyball, softball, soccer, and baseball. Instructions for filling out this questionnaire:

- The offeror will fill out section A below AND the contractor name and contract number at the top of each page of this questionnaire.

- The evaluator will review section A and confirm if it is correct. Please document any discrepancies in the remarks section below. The Evaluator will fill out section B and section D below. All sections must be filled out and the signature of the evaluator must be provided. The evaluator must provide an overall rating for the offeror’s performance and this rating must be fully justified in the remarks section below.

Give concrete examples of how the offeror met, exceeded, or failed to meet the contract requirements.

The government may follow-up via telephone to clarify comments by evaluators.

A. GENERAL INFORMATION: Please correct 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:_____________________________________________________ Annual Dollar/Euro Amount Provided by Offeror:____________________________________________ Sport Disciplines Officiated:______________________________________________________________ Approximate Number of Games Officiated per year:___________________________________________ Period of Performance Provided by Offeror:_________________________________________________ Contractor performed as the Prime Contractor Sub-Contractor Key Personnel

B. RESPONDENT/EVALUATOR INFORMATION: To be completed by the respondent and returned directly to the contracting office:

Name of Respondent:_______________________ Title:_____________________________________

Address: _______________________ Telephone Number:_____________________________ _______________________ Fax Number:___________________________________ _______________________ Email Address:_________________________________

C. E-MAIL COMPLETED SURVEY FORM TO:

Name: Thomas R. Buena Office: 700 CONS/LGCA E-Mail: thomas.buena@us.af.mil Voice #: 0631 536 7509 or DSN #: 489-7509

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A

NARRATIVE EXPLANATION FOR ALL RATINGS IN THE REMARKS SECTION BELOW.

E G S M U N Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

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

Performance meets contracual 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.

The contractor: E G S M U N

1.

Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems.

5. Demonstrated effective quality control and/or inspection procedures to meet contract requirements.

6. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

7. Provided timely resolution of contract discrepancies.

8. Identified problems as they occurred.

9. Suggested alternative approaches to problems mailto:thomas.buena@us.af.mil

The contractor: E G S M U N

10. Displated initiative to solve problems.

11. Developed realistic progress schedules.

12. Met established contract schedules.

13. Was responsive to contract changes.

14. Provided adequate project supervision.

15. Cooperated with Government personnel after award.

16. How would you rate the contractor’s overall performance?

17. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain the outcome in “remarks”. YES/NO

18. Is the contractor rated in CPARS? YES/NO

19. Would you award another contract to this contractor? If not, explain in “remarks”. YES/NO

20. Was the contractor ever late or absent from sporting events? If so, please explain in “remarks”. YES/NO

21.

Did contractor personnel exhibit unprofessional behavior or appearance during a sporting event? If so, explain in “remarks” the situation and what the corrective action was.

YES/NO

REMARKS:__________________________________________________________________________

Evaluator Name: ___________________ Signature:__________________________________ Address: _______________________ Fax Number:_______________________________ _______________________ Email:_____________________________________ _______________________ Telephone Number:__________________________