Attachment_8_-_Past_Performance_Information_Sheet.docx

For Official Use Only When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Solicitation FA8003-19-R-A002 Attachment 8: Past Performance Information Sheet The 771 Enterprise Sourcing Squadron of the Air Force Installation Contracting Agency (AFICA) is in the process of competitively selecting a source for an Expeditionary/Contingency Medical Materiel Services program. The ECMM program is predominantly general medical warehousing operations. The program also includes medical logistics support personnel for staffing at various locations worldwide, including travel to support unstaffed locations.

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. In order to meet the acquisition milestones, we request your written response no later than [date] calendar days after your receipt of this letter. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

The offeror who has nominated you as a Point of Contact for this effort has completed Section 1 below. In order to provide a complete assessment, please complete Section 2 through Section 5 in the attached Past Performance Information Sheet. See Attachment 2 for Relevant Work descriptions.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to joann.parks@us.af.mil. Please call JoAnn Parks at 937-257-5791 if you have any questions. 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.

JoAnn Parks, Procuring Contracting Officer

Attachements :

Past Performance Information Sheet Relevant Work Descriptions

Section 1: Contract Identification (Completed by the Offeror)

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

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. 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. Contract Included (Please select all that apply):

☐ General Warehousing Support Services ☐ Overseas Staffing ☐ Travel Planning and Travel Budget Forecasting ☐ Medical Logistics ☐ Biomedical Equipment Technician (BMET) Support ☐ Other

J. Description of work performed:

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

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor

Note: If offeror holds or has held other contracts with your agency/organization in the last three (3) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of work performed 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/fax number/e-mail address:

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

E. Other suggested points of contact:

Section 4: Effort/ Contract Specifics If any information provided by the Offeror in Section I.C. above is incorrect and/or requires more detail, please elaborate below.

☐ Information in Section 1 is correct (Skip to Section 5)

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

4. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

5. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

6. Reason for difference (if applicable):

H. Contract Dollar Value

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

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

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

I. Contract Included (Select all that Apply):

☐ General Warehousing Support Services ☐ Overseas Staffing ☐ Travel Planning and Travel Budget Forecasting ☐ Medical Logistics ☐ Biomedical Equipment Technician (BMET) Support ☐ Other

J. Description of work performed:

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

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor

Section 5: Performance Information

In the table 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:

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

SUPPORTING INFORMATION:

2. Demonstrated the 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. Provided 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. Displayed initiative to solve problems.

10. Met established project schedules.

11. Met contract terms without failure.

12. Was responsive to contract changes.

13. Provided adequate project supervision.

14. Demonstrated cost control.

15. Paid subcontractors/suppliers in a timely manner.

16. Cooperated with Government personnel after award.

17. How would you rate the contractor's overall performance on this contract?

18. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.

EXPLANATION:

☐ Yes ☐ No

19. Would you award another contract to this contractor? If not, explain.

EXPLANATION:

☐ Yes ☐ No

Additional remarks:

[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: joann.parks @us.af.mil or Mail to: JoAnn Parks 1940 Allbrook Drive Area A, Bldg. 1, Rm. 300 Wright-Patterson AFB, OH 45430 Relevant Work Descriptions:

1. General Warehousing Support Services. Past experience includes but is not limited to: warehouse management, receipt, inspection, pallet assembly builds, sustainment, repacking and distribution services, procurement management within a supply system, technician functions, inventory management, Hazardous Materiel management, quality control establishment and management, disposal and removal of materiel, controlled items management, transportation management, overseeing/managing an assemblage/pallet production plan.

2. Overseas Staffing. Past experience includes but is not limited to: providing and managing staffing at overseas locations and working under Status of Forces Agreements (SOFAs).

3. Travel Planning and Travel Budget Forecasting. Past experience includes but is not limited to: planning site visits, forecasting the travel budget for planned/unplanned trips, application of the Joint Travel Regulations (JTR) to travel budgets, and providing travel trip reports to customers.

4. Medical Logistics Experience. Past experience includes but is not limited to: providing general medical logistics and materiel management services; providing medical logistics and materiel management services for War Readiness Materiel and Medical Contingency-Chemical Biological and Radiological and Nuclear programs; assembly, sustainment, deployment, reconstitution, and modernization of medical materiel operations; providing medical logistics support functions to ensure individual assemblages are arranged in predetermined and standardized configurations; awareness and/or utilization of government medical information systems; conducting dated item management; awareness and/or utilization of: excess materiel program, disposal and destruction program, controlled medical items program, hazardous waste management program; and preparing medical materiel for deployment, emergency homeland response operations, or home station exercise support.

5. Biomedical Equipment Technician (BMET) Support for equipment inspections and calibrations. Past experience includes but is not limited to: assemblage, installation, inspection, calibration, and repair of new and used biomedical equipment; management of medical equipment using a supply system/program; arrangement of the preventative maintenance and repair of equipment assets.

For Official Use Only Page 3 of 8