Attachment_6_-_FES_PPE_Past_Performance_Questionnaire.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(ii) 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, and local government as well as 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 meets contractual requirements. Work was accomplished with some minor problems for which corrective action taken by the contractor were satisfactory.

Unacceptable – Performance does 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.

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

A. CONTRACTOR IDENTIFICATION

i. Contractor POC name and Position/Duty Title Address

ii. Company/Organization name, email & telephone number of the Contractor POC

iii. Contract Number

iv. Prime/Subcontractor or Key Personnel Designation

v. Brief Description of Work

vi. Period of Performance

vii. Contract Dollar Value (Annual and Aggregate)

viii. Verified, up-to-date name, email & telephone number of the identified Customer

POC

FES PPE Past Performance Questionnaire

FOR OFFICIAL USE ONLY

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

i. Contractor POC name and Position/Duty Title Address

ii. Company/Organization name, email & telephone number of the Contractor POC

iii. Contract Number

iv. Prime/Subcontractor or Key Personnel Designation

v. Brief Description of Work

vi. Period of Performance

vii. Contract Dollar Value (Annual and Aggregate)

SECTION II. General Information (To be completed by Respondent)

RESPONDENT IDENTIFICATION

i. Contractor POC name and Position/Duty Title Address

ii. Company/Organization name, email & telephone number of the Contractor POC

iii. Contract Number

iv. Prime/Subcontractor or Key Personnel Designation

v. Brief Description of Work

vi. Period of Performance

vii. Contract Dollar Value (Annual and Aggregate)

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

A. Compliance with Technical Specifications. Were the Products and/or Services 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

FES PPE Past Performance Questionnaire

FOR OFFICIAL USE ONLY

C. Product Quality & Workmanship. Were there any product 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.

D. Product Quality & Incidents of Injury. Were there any product 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 – All 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 – The majority of products provided by the Offeror DID NOT require warranty work within the first six (6) months of use.

F. 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 – Several products provided by the Offeror were delivered later than the agreed upon delivery date.

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

FES PPE Past Performance Questionnaire

FOR OFFICIAL USE ONLY

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

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

H. 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.

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

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

Unacceptable – Performance does 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. Please provide any other relevant information relative to the Offeror’s performance.

SIGNATURE OF RESPONDENT

CUSTOMER PAST PERFORMANCE QUESTIONNAIRE