Attachment_13,_Past_Performance_Questionnaire.pdf

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY 1

ATTACHMENT 13

Past Performance Questionnaire

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOURSELF:

Name/Signature and Role Relative to Contract (e.g. Buyer, Program Manager):

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Agency or Business:

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Address:

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Telephone No.: Choose an item. Click here to enter text.

FAX No.: Click here to enter text.

Return your completed questionnaire either electronically or by mailing. If sending electronically, email to Kevin Beck at kevin.beck.8@us.af.mil or Travis Simmons at travis.simmons.3@us.af.mil. If mailing, mail directly to:

AFLCMC/WNKAC

ATTN: Kevin Beck or Travis Simmons, 235 Byron Street, Suite 19A Robins AFB, GA 31098-1813

Reference: RFP: (FA8534-17-R-0007)

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED

SENSITIVE AND SHALL NOT BE RELEASED TO THE OFFEROR.

Part I. SPECIFIC PROGRAM INFORMATION.

Contractor/Business: Click here to enter text.

CAGE Code: Click here to enter text.

Program Title and Brief Description:

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Role in the Program/Work Performed As:

☐ Prime ☐ Subcontractor ☐ Vendor/Supplier

Contract Number: Click here to enter text. Number of Years: Click here to enter text.

Basic: Click here to enter text. Option: Click here to enter text.

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY 2

Contract Type(s): List all applicable contract types, i.e. Firm-Fixed-Price, Time & Materials, Cost, etc.:

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PART II. GENERAL PROGRAM INFORMATION.

Period of Performance:

1. Original Schedule (assuming all options exercised): Beginning Date Click here to enter a date. through Click here to enter a date.

2. Current Schedule (assuming all options exercised): Beginning Date Click here to enter a date. through Click here to enter a date.

3. Reason for difference (if applicable):

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Contract Dollar Value: Click here to enter text.

1. Original MAX Contract $ Value (assuming all options exercised):

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2. Current MAX $ Value (assuming all options exercised):

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3. Primary Causes of Changes:

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NOTE: In Part III., if your response is anything other than “Satisfactory,” please provide supporting documentation in “Additional Remarks” on page Error! Bookmark not defined.

of 5 or on an additional sheet to this document (which is in Word format). If supporting documentation is not provided for ratings that are other than “Satisfactory,” the ratings will be considered to be unsubstantiated and will be interpreted as Satisfactory.

PART III. PERFORMANCE ASSESSMENTS.

Please place an X in the appropriate rating column for each of the following questions:

N =Neutral U=Unsatisfactory M=Marginal S=Satisfactory G=Very Good E=Exceptional

N U M S G E

1. Extent to which Company’s products and/or services met the specification /performance requirements

2. Configuration Management (first product delivered same as last)

3. Quality of Completed Product

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY 3

4. Overall management of subcontracting efforts

5. Customer’s Satisfaction with corrective actions

6. Adequate Number of Dedicated Resources For Your Program

7. Timely recognition and notification of administrative, engineering, production, problems affecting the program

8. Company performed independently without significant customer direction/oversight?

9. Monitoring of Program Schedules and Critical Milestones:

10. Completed Work on Time

11. Overall management of concurrent efforts in different geographic locations

12. Performance in CONUS environment

13. Performance in OCONUS environment

14. Life cycle management (tracking/resolution of defects, systemic updates, and common maintenance issues)

15. Management of technical data (approved submission of USAF-format drawings and/or TO changes)

16. Performance of Acceptance Testing (inspection, functional check, interface check, demonstration of serviceability, submission of test plans/reports)

17. Has action been initiated to cancel or terminate the contract for default? If yes, explain.

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18. Have there been any disputes/claims relative to the contract? If yes, explain.

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY 4

19. Describe the contractor’s or company’s strong and/or weak points identified as a result of technical performance and any technical performance risk identified during the life of the contract.

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20. If given a choice, would you award to this contractor again? If not, please explain.

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21. Do you feel you “got what you paid for”? Please explain.

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22. Additional Remarks.

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY 5

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

ASSESSMENT RATING SYSTEM

E Exceptional/Blue During the contract period, contractor performance is meeting (or met) all contract requirements and consistently exceeding (or exceeded) many. Very few, if any, minor problems encountered.

Contractor took immediate and effective corrective action.

G Very Good/Purple During the contract period, contractor performance is meeting (or met) all contract requirements and consistently exceeding (or exceeded) some. Some minor problems encountered. Contractor took timely and effective corrective action.

S Satisfactory/Green During the contract period, contractor performance is meeting (or met) all contract requirements. For any problems encountered, contractor took effective corrective action.

M Marginal/Yellow During the contract period, contractor performance is not meeting (or did not meet) some contract requirements. For problems encountered, corrective action appeared only marginally effective, not effective, or not fully implemented.

Customer involvement was required.

U Unsatisfactory/Red During the contract period, contractor performance is failing (or failed) to meet most contract requirements. Serious problems encountered. Corrective actions were either ineffective or non-existent. Extensive customer oversight and involvement was required.

N Neutral/White Unable to provide a rating. Contract did not include performance for this aspect. Do not know.

NOTICE TO QUESTIONNAIRE RESPONDENTS: Please do not include this page when returning the completed questionnaire.