Past_Performance_Questionnaire_Refuse.pdf

FA8601-13-R-0026

WRIGHT-PATTERSON AIR FORCE BASE

Integrated Solid Waste Management

Attachment 5

February 2013

PAST PERFORMANCE QUESTIONNAIRE

SOURCE SELECTION SENSITIVE WHEN FILLED IN IAW FAR 3.104-3

AFLCMC/PZIOB at Wright-Patterson Air Force Base (WPAFB), Ohio solicits your input regarding a contractor that has performed services for you in the past or is currently performing services for you. The following questionnaire will be used as part of the Government’s evaluation of the contractor’s proposal for Integrated Solid Waste Management to be performed on WPAFB. Please complete, sign and return the questionnaire directly to the Government preferably by e-mail.

Only questionnaires received directly from respondents will be used in the evaluation.

Signed and completed questionnaires must arrive at AFLCMC/PZIOB not later than Noon

(EST) on 21 March 2013. Any questions should be directed to Trisha Buddelmeyer at

(937) 522-4639 or Trisha.Buddelmeyer@wpafb.af.mil.

a. E-mail signed and completed questionnaires to Trisha.Buddelmeyer@wparfb.af.mil as a file attachment in the Adobe Acrobat format (*.pdf). NOTE: Questionnaires returned via e-mail must contain a subject line that reads “FA8601-13-R-0026 Integrated Solid Waste

Management.” E-mail filters at Wright-Patterson Air Force Base are designed to filter e-mails without subject lines or with suspicious subject lines or contents (i.e., .exe or .zip files).

Therefore, if the prescribed subject line is not included or the attachment is not in the Adobe

Acrobat .pdf format, the e-mail may not get through the e-mail filters.

b. We recommend that you supplement your own knowledge of the offeror’s performance with the judgment of others in your organization. If you need more space than is provided, please attach a separate sheet to the end of this questionnaire.

c. Complete a separate questionnaire for each contract the contractor performed for your organization.

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I. RESPONDENT INFORMATION:

a. Name of Respondent/Evaluator:

b. Name and Address of Respondent’s Organization:

c. Organizational Telephone No.:

d. Fax Number:

e. E-mail Address:

f. How long were you involved with the contract being evaluated?

II. CONTRACTOR BEING EVALUATED

a. Name of the Firm Being Evaluated:

b. Contract Number or Other Reference Number:

c. Description of Services:

d. Did the contract involve:

performing work with Integrated Solid Waste Management? ( ) Yes ( ) No removal of construction debris and yard waste? ( ) Yes ( ) No

e. Where was the work performed? (i.e. City and State or Country)

f. Period of Performance: (How long did the contractor perform services for you? What was the start and ending dates of the contract?)

g. US GOVERNMENT CONTRACTS ONLY: Was the contract terminated prior to the agreed upon period of performance? ( ) Yes ( ) No

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If yes, explain.

i. Contract Type:

ii. What was the basis for the contractor’s compensation?)

j. Contract Value for the Performance Period Sated in U.S. Dollars:

k. Did this company use any subcontractor(s) to accomplish the required work?

( ) Yes ( )No

l. If subcontractors were used, what was the approximate percentage of the work subcontractor(s) performed? ____%

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III. EVALUATION: For questions pertaining to Quality Control, Scheduling Methodologies, Personnel, and Supplies/Equipment, circle a letter or “N/A” based on the scale below to indicate your agreement or disagreement with statements regarding the contractor’s performance. Please provide an explanation for ratings other than Satisfactory (S).

E Excellent: Performance meets all contractual requirements and exceeds some requirements.

S Satisfactory: Performance meets all contractual requirements.

M Marginal: Performance does not meet some contractual requirements.

U Unsatisfactory: Performance does not meet most contractual requirements.

N/A Not Applicable or Not Observed.

a. Quality Control

1. The contractor employed qualified personnel whose primary duty under the contract was to manage the contractor’s quality control plan.

E S M U N/A

2. The contractor maintained a comprehensive, flexible, fully documented quality control plan throughout the contract performance period.

3. The contractor’s quality control records pertaining to performance of this contract was readily available.

E S M U N/A

4. The contractor communicated openly regarding quality control matters including performance problems, corrective actions planned or taken and their effectiveness.

E S M U N/A

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5. The contractor accounted for keys, identification credentials, access codes, etc.

and ensured only authorized personnel had access to facilities in which services were performed.

E S M U N/A

6. The contractor’s quality control plan was effective in ensuring all services were performed in accordance with contract requirements.

E S M U N/A

b. Scheduling Methodologies

1. The contractor developed effective work schedules and crew assignments that ensured compliance with comply with contract requirements.

E S M U N/A

2. The contractor routinely responded promptly to emergency situations with no negative Impact on other contract requirements.

E S M U N/A

3. The contractor used a sufficient number of employees to effectively perform the requirements of the contract.

E S M U N/A

c. Personnel

1. The contractor employed qualified personnel to perform the services.

2. The contract manager and other key personnel had the right amount and types of experience to manage this contract.

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3. The contractor maintained an effective training program.

e. Overall Evaluation

1. Please indicate your overall satisfaction with the contractor’s performance by circling the rating code E, S, M or U below. The description of each rating is to its right. Please provide an explanation for ratings of E, M or U.

CODE PERFORMANCE LEVEL

E Excellent: Performance meets all contractual requirements and exceeds some requirements.

S Satisfactory: Performance meets all contractual requirements.

M Marginal: Performance does not meet some contractual requirements.

U Unsatisfactory: Performance does not meet most contractual requirements.

Explanation of rating for E,M, U:

2. In a competitive situation, all other factors being equal, would you award this contractor another contract for similar services based on their past performance?

( ) Yes ( ) No

Explain

Remember that respondents are to return all questionnaires directly to AFLCMC/PZIOB via e-mail to trisha.buddelmeyer@wpafb.af.mil. Completed and signed questionnaires must arrive not mailto:trisha.buddelmeyer@wpafb.af.mil

Integrated Solid Waste Management

Attachment 5 later NOON (EST), 21 March 2013. Please address questions to Trisha Buddelmeyer at (937)

522-4639.