Attachment_6_-_FES_PPE_Past_Performance_Questionnaire_boxed.pdf

FA8056-17-R-0001

Attachment 6

FES PPE Past Performance Questionnaire

FOR OFFICIAL USE ONLY

CUSTOMER PAST PERFORMANCE QUESTIONNAIRE

SOURCE SELECTION SENSITIVE WHEN FILLED IN IAW FAR 3.104-3

The 771st Enterprise Sourcing Squadron (ESS) located at Wright-Patterson Air Force Base (WPAFB), Ohio solicits your input regarding an Offeror (manufacturer or distributor, listed in SECTION I – A(i) below) that has previously or is currently providing Fire Emergency Services Personal Protective Equipment (FES PPE) to you. The following questionnaire is an attachment to the Offeror’s proposal for a United States Air Force (USAF) FES PPE contract. Your feedback is very important to this program and we appreciate your willingness to participate by providing the requested information (in SECTION II below).

The questions pertain to the Offeror’s record of past (within five years) and current performance. The information you provide will be used in the awarding of a Department of Defense (DoD) contract;

therefore, it is important that your information be as factual and accurate as possible. The past performance evaluation considers each Offeror’s demonstrated recent and relevant record of performance in supplying products and services that meet the solicitation requirements. Please provide examples and/or explanations, which can include Federal, State, local government and private, for efforts similar to this Government requirement (use additional pages if necessary). In the case of an Offeror without a record of relevant past performance or for whom information on past performance is not available, the Offeror may not be evaluated favorably or unfavorably on past performance.

The following adjectival ratings shall be used in your response:

Acceptable – Performance met contractual requirements. Work was accomplished with some minor problems for which corrective action taken by the contractor was satisfactory.

Unacceptable – Performance did not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

Unknown – Information on past performance is not available or is so sparse that no meaningful past performance rating can be reasonably assigned.

SECTION I. General Information (To be completed by Offeror)

A. OFFEROR INFORMATION

i. Offeror Company Name

ii. Offeror Company Address

iii. Offeror Point of Contact (POC) Name

iv. Offeror POC Position/Title

1516589996C Typewritten Text

1516589996C Typewritten Text

v. Offeror POC Email

vi. Offeror POC Telephone Number

B. IDENTIFICATION OF CUSTOMER’S POINT OF CONTACT (To be completed by

Offeror)

i. Customer Company Name

ii. Customer Address

iii. Customer POC Name

iv. Customer Position/Title

v. Customer Email

vi. Customer POC Telephone Number

vii. Contract Number/Title

viii. Prime/Subcontractor (See above)

ix. Brief Description of Work

x. Model Number or Product Series Provided to Customer

xi. Period of Performance

xii. Contract Dollar Value

SECTION II. General Information (To be completed by Customer POC)

CUSTOMER IDENTIFICATION

i. Customer Company Name

ii. Customer Address

iii. Customer POC Name

iv. Customer POC Position/Title

v. Customer POC Email

vi. Customer POC Telephone Number

vii. Contract Number/Title

viii. Brief Description of Work

ix. Model Number or Product Series

x. Period of Performance

xi. Contract Dollar Value

INSTRUCTIONS: For the items A through K below, select Yes, No, or Unknown/Not Applicable.

A. Compliance with Technical Specifications. Were the products, services, documents, and/or deliverables provided by the Offeror in compliance with the requested technical specifications?

Yes – The majority of products provided by the Offeror were in compliance with the requested technical specifications.

No – Several products provided by the Offeror were NOT in compliance with the requested technical specifications.

Unknown/Not Applicable

B. Compliance with Terms & Conditions. Were the products, services, documents, and/or deliverables provided by the Offeror in compliance with all terms and conditions of the contract or agreement?

Yes – The majority of items provided by the Offeror were in compliance with the stated terms and conditions.

No – Several items provided by the Offeror were NOT in compliance with the stated terms and conditions.

Unknown/Not Applicable

C. Product Quality & Workmanship. Were there any deficiencies or failures related to the products provided by the Offeror?

Yes – Several products provided by the Offeror were deficient or failed.

No – The majority of products provided by the Offeror were free of deficiency or failure.

Unknown/Not Applicable

D. Product Quality & Incidents of Injury. Were there any deficiencies or failures that resulted in injury to the user related to products provided by the Offeror?

Yes – A single product or more provided by the Offeror were deficient or failed resulting in the injury of the user.

No – Numerous products provided by the Offeror were free of deficiency or failure and there were no related user injuries.

E. Product Quality & Warranty. Were there any products provided by the Offeror that required the exercise of a warranty within the first six (6) months of use?

Yes – Several products provided by the Offeror required warranty work within the first six (6) months of use.

No – Numerous products provided by the Offeror DID NOT require warranty work within the first six (6) months of use.

F. Sizing Kits. If applicable, were the sizing kits provided by the Offeror effective toward receiving properly sized equipment?

Yes – A majority of the products provided by the Offeror were properly sized and did not require resizing due to sizing kit discrepancies.

No – Several of the products provided by the Offeror did require resizing due to sizing kit discrepancies.

Unknown/Not Applicable

G. Unencumbered Movement. If applicable, did the Offeror’s products provide adequate unencumbered movement (i.e., ease of motion)?

Yes – A majority of the products provided by the Offeror did offer adequate unencumbered movement.

No – Several of the products provided by the Offeror failed to offer adequate unencumbered movement.

H. Delivery & Timeliness. Were Offeror’s products delivered in a timely manner (i.e., on or before the agreed upon delivery date)?

Yes – The majority of products provided by the Offeror were delivered in a timely manner.

No – Numerous products provided by the Offeror were delivered later than the agreed upon delivery date.

I. Shipping & Handling. Were the Offeror’s products free of any damage as a result of shipping and handling?

Yes – All the majority of products provided by the Offeror were free of damage as a result of shipping and handling.

No – Numerous products provided by the Offeror were delivered with damage as a result of shipping and handling.

J. Customer Service & Communication. Were interactions with the Offeror positive in terms of customer service and communication?

Yes – The majority of interactions with the Offeror were positive in terms of customer service and communication.

No – Several interactions with the Offeror were NOT positive in terms of customer service and communication.

K. Overall Performance. How would you rate the Offeror’s overall performance?

Acceptable – Performance met contractual requirements. Work was accomplished with some minor problems for which corrective action taken by the contractor were satisfactory.

Unacceptable – Performance did not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

Unknown – Information on past performance is not available or so sparse that no meaningful past performance rating can be reasonably assigned.

General Comments. If applicable, please provide additional information relative to the Offeror’s performance.

SIGNATURE OF CUSTOMER POC PRINTED NAME OF CUSTOMER POC

TITLE OF CUSTOMER POC

CUSTOMER PAST PERFORMANCE QUESTIONNAIRE