Attachment13,PastPerformanceQuestionnaire.docx

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

ATTACHMENT 13

Past Performance Questionnaire

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOURSELF:

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

Agency or Business: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________

Address: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Telephone No. _______________________________

FAX No. ____________________________________

Return your completed questionnaire either electronically, by mail to Crystal Crawford at crystal.crawford.1@us.af.mil or Travis Simmons at travis.simmons.3@us.af.mil. If mailing, mail directly to:

AFLCMC/WNKAC

ATTN: Crystal Crawford 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: _____________________________________________ CAGE Code: __________ Program Title and Brief Description: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Role in the Program/Work Performed As: _____Prime _____Subcontractor _____Vendor/Supplier

Contract Number: _________________________ Number of Years: ______ Basic:________ Option: _________

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

PART II. GENERAL PROGRAM INFORMATION.

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) __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Contract Dollar Value:

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

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

3. Primary Causes of Changes: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

NOTE: In Part III., should your response be other than “satisfactory,” please provide supporting documentation in “Additional Remarks” on page 4 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 check the appropriate rating for each of the following questions:

N/A=Not Applicable U=Unsatisfactory M=Marginal S=Satisfactory V=Very Good E=Exceptional

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:

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

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

13. 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. _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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

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

16. Additional Remarks.

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

ASSESSMENT RATING SYSTEM

E EXCEPTIONAL: Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD: Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY: Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL: Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE: Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

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

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY