ATTACHMENT 10 - Past Performance Questionnaire.docx

Controlled Unclassified Information When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

FA700023R0013 - Attachment 10: Performance Questionnaire The 10th Contracting Squadron of the Air Force us in the process of competitively selecting a source for a 10th Logistics Readiness Squadron program.

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

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. To meet the acquisition milestones, we request your written response no later than [insert number of days]. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to:

Susan Ulma susan.ulma@us.af.mil Tammy Martin tammy.martin.6@us.af.mil Fenton Fitzgerald fenton.fitzgerald.2@us.af.mil

Your completed questionnaire will become a part of the official Source Selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

1 Atch Past Performance Questionnaire

Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Period of Performance (assuming all options exercised):

Reason for difference (if applicable):

H. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

I. Description of work performed:

J. Was this a competitively awarded contract? ☐ Yes ☐ No

K. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

L. Contract Areas of Performance:

(Commercial, DoD, Other Government) Number of Personnel Per Area

Supply Operations

Grounds Fuels

Aviation Fuels

Munitions

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / fax number / e-mail address:

D. Respondent’s position (e.g., Program Manager, PCO/ACO, etc.):

E. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

F. Other suggested points of contact:

Section 4: Performance Information

In the tables below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

TP1. How smoothly and effective was the contractor in maintaining continuity of mission support while transitioning/phasing in resources and personnel to support requirements?

SUPPORTING INFORMATION:

P1. How effective was overall contract management (including ability to effectively lead, manage, control, and deliver on-time)?

P2. How effective was the quality control and/or inspection procedures to meet contract requirements? Were any identified deficiencies corrected in timely manner and pursuant to their quality control procedures?

P3. Did the contractor identify problems, suggest alternatives to resolve, and display initiative to resolve with little guidance from the customer?

P4. How effectively was the contractor able to hire and retain a qualified workforce to this effort to include key personnel? What was the average timeframe to hire new employees?

P5. How effective was the contractor’s communication and timeliness of completing milestones, deliverables, and administrative requirements to include responding to correspondence? Was the contractor responsive to technical and/or contractual direction?

P6. How well did the contractor coordinate the efforts of subcontractors with customers to accomplish tasks and resolve problems? Is the contractor managing subcontractors to meet the requirements of the contract?

MISSION FOCUS AREA – Complete those mission applicable to this specific contract or task order. For example, do not complete the Munitions mission focus area if the offeror did not perform in that area.

Supply Operations (Basis for Rating is required) For this section, supply operations include equipment accountability in Defense Property Accountability System (DPAS), customer service, storage, disposition, and execution of the supply and weaponry accountability mission. (Note: execution includes, but is not limited to, customer service utilizing DPAS, base-wide equipment management, weapons security, clearing, disassembly, assembly, inspection, cleaning, HAZMAT, and function check of military weaponry).

Supply Operations: In which area of supply does the contractor have prior knowledge, skills, and abilities to perform supply functions:

Check All Applicable:

S1. DPAS Utilization: How well did the contractor utilize DPAS or commercial equivalent? Where there any discrepancies or errors created by the contractor? How many? Were they resolved in a timely manner?

S2. Weapons Program: How effective was the contractor’s overall weapons management program? Did the contractor have any reported weapons violations? Number of occurrences? If so, please clarify violation and effectiveness of the corrective actions.

S3. Mobility Program: How well did the contractor manage, control, and provide preventative maintenance on Mobility Individual Protective Equipment (IPE), Joint Service General Purpose Mask (JSMLT), and assets?

S4. Shipping and Receiving Program: How effective did the contractor manage, control, prepare, handle, and inspect hazardous material shipments both inbound and outbound. Has the contractor had any reportable HAZMAT incidences. If so, please clarify violation and effectiveness of the corrective action.

Ground & Aviation Fuels Operations (Basis for Rating is required) For this section, fuel operations, both ground and aviation, include the proper execution of all fuels related functions. Execution includes, but not limited to, certification and training, vehicle maintenance, fuel sampling, fueling, and defueling, security, and accountability.

F1. Fueling Certification: How effective was the contractor with maintaining qualified/certified personnel (CDL/HAZMAT) to accomplish fueling and defueling operations of both ground and aviation assets? Where there any reported mishaps during the duration of the contract? If so, please clarify mishap and effectiveness of corrective actions.

F2. Fuel Truck Operations: How effective was the contractors fuel truck operations, to include, proper maintenance, registration, and following of all DOT regulations? Has the contractor every had a reportable fuel spill? If so, please clarify mishap and effectiveness of corrective actions.

F3. Fuels Systems Knowledge: How effective was the contractor’s overall data base fuels operations utilization, such as, Fuels Manager Defense (FMD), Enterprise Business System (EBS), or equivalent commercial data bases?

Munitions Operations (Basis for Rating is required) For this section, munitions operations, include the proper execution of all munitions related functions. Execution includes, but not limited to, receiving, issuing, accountability, storage, handling, security, customer service, and safety.

Munitions Operations: In which area of supply does the contractor have prior knowledge, skills, and abilities to perform munitions functions:

Check All Applicable:

M1. Daily Munitions Functions: How effective was the contractor’s munitions operations program, such as GACP/TICMS, or commercial equivalent data base, for the movement and tracking of munitions? Did the contractor perform separation of duties between personnel issuing munitions and accountability of munitions systems?

M2. Munitions Safety and Security/Certification: How effective was the contractor’s munitions safety and security and certification programs? Has the contractor every had a reportable munitions mishap? If so, please clarify mishap and effectiveness of corrective actions.

Government Contracts Only: Was this contract partially or completely terminated for default or convenience, or are there any pending terminations?

☐ Yes ☐ Default ☐ Convenience ☐ Pending Terminations ☐ Cure Notice ☐ No

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules).

SECTION 5: GENERAL COMMENT

Given what I know today about the contractor’s ability to execute what he promised in his proposal, I [ click and select an item ] award to him today given that I had a choice.

REMARKS:

Please provide any additional comments concerning this contractor’s performance, as desired.

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

E-Mail to:

Susan Ulma susan.ulma@us.af.mil Tammy Martin tammy.martin.6@us.af.mil Fenton Fitzgerald fenton.fitzgerald.2@us.af.mil

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