Attachment_3_-_Past_Performance_Questionnaire.docx

MEMORANDUM FOR

FROM: 771 ESS/EGB

SUBJECT: Request for Past and Present Performance Evaluation When Filled In This Document Is Source Selection Sensitive IAW FAR2.101 and FAR 3.104

TO:

1. You have been identified as a point of contact for a past performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for a Transient Alert Service strategic sourcing contract with the 771st Enterprise Sourcing Squadron, Air Force Installation Contracting Agency, Wright-Patterson AFB, OH.

2. Your Prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, please contact TSgt Joshua Samples at 431-278-6421 or email joshua.samples@us.af.mil.

Attachments:

1. Past and Present Performance Questionnaire

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. UGENERAL INFORMATIONU: Please correct any 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: ___________________ Dollar Amount: ________*

Contract Period or Dates of Performance Provided by Offeror: ______________________* Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. URESPONDENT INFORMATIONU:

Name of Respondent: _____________________ Title: ____________________________

Address: _____________________ Telephone Number: ____________________

_____________________________ Fax Number: _________________________

_____________________________ Email Address: _______________________

C. UEMAIL COMPLETED SURVEY FORM TOU: XXXXXXXXXXX@us.af.mil and XXXXXXXX@us.af.mil

D. UPERFORMANCE INFORMATIONU: 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 ANY RATINGS OF M or U.

E

Exceptional G

Good S

Satisfactory M

Marginal U

Unsatisfactory N

Neutral

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix above.

technical and administrative abilities needed to meet contract requirements.

necessary, qualified personnel during the contract period.

YES/NO

YES/NO

Remarks:______________________________________________________________________