Attachment 6 Past Performance Questionnaire_.pdf
PDF 253 KB Posted
- Attached to
- Site Support Services
- Solicitation number
- FA875126R0004
About this file
This is a Past Performance Questionnaire template for federal contract solicitation FA875126R0004, Rome Research Site - Site Support Services at the Air Force Research Laboratory in Rome, New York. The document is divided into two sections: Section A is completed by the offeror for each reference and submitted with the proposal, while Section B is completed by past performance references and submitted directly to the Contract Specialist.
Section A requires offerors to provide reference information including company name, address, contract number, program name, contract type (Firm-Fixed Price, Cost-Reimbursement, or Other), description of work, award and completion dates, contract amounts, and detailed comments regarding compliance with contract terms and conditions, any unacceptable performance, and major subcontractors involved. Section B, to be completed by references, requests the reference contact information, relationship with the offeror, subcontracting details, and performance ratings across six evaluation areas: Technical Capability (10 criteria), Timely Performance (5 criteria), Management Effectiveness (7 criteria), Contract Administration (2 criteria), Compliance with Security Standards (7 criteria), and Overall Performance (1 criterion). References rate performance on a six-point scale: Exceptional, Good, Satisfactory, Marginal, Unsatisfactory, or Neutral. The proposal response date is 27 February 2026, and references should submit completed questionnaires to Contract Specialist Brooke McDonald at (315) 330-3979 or Brooke.McDonald@us.af.mil.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
Attachment 6
FA875126R0004
INSTRUCTIONS FOR OFFEROR
1. Offerors will complete Section A of the questionnaire (Page 2 & 3) for each reference and include with their proposal. The offeror will submit Section B of the questionnaire directly to their references and request the reference return the questionnaire directly to the Contract Specialist identified below. Offeror will complete Block 2 of Section B (Contract number and Program Name) before submitting to their references.
PROPOSAL RESPONSE DATE: 27 February 2026
CONTRACT SPECIALIST:
NAME: BROOKE MCDONALD
TEL: (315) 330-3979
EMAIL: Brooke.McDonald@us.af.mil mailto:Brooke.McDonald@us.af.mil
FA875126R0004
SECTION A:
Offerors will complete Section A of the questionnaire (Pages 2 & 3) for each reference and include with their proposal.
1. COMPANY NAME/ REFERENCE NAME: __________________________________________
ADDRESS: ____________________________________________________________________
TEL: ___________________________ FAX: _____________________________
EMAIL: ____________________________________________________________________
2. CONTRACT #: _______________________PROGRAM NAME:____________________________
3. CONTRACTING OFFICER (IF DIFFERENT FROM REFERENCE): ________________________
ADDRESS: ____________________________________________________________________
TEL: ___________________________ FAX: _____________________________
EMAIL: ____________________________________________________________________
4. CONTRACT TYPE: Firm-Fixed Price Cost-Reimbursement Other (describe)
5. DESCRIPTION OF WORK: _______________________________________________________
6. BRIEF DESCRIPTION OF THE EFFORT Prime ____ or Subcontractor ____
FA875126R0004
7. AWARD DATE: _______________ ___ SCHEDULED COMPLETION: ___________________
CURRENT / FINAL COMPLETION DATE (if different): _________________________________
8. AMOUNT PER YEAR: ___________________ CONTRACT TOTAL AMOUNT: ____________________
CURRENT / FINAL AMOUNT (if different): _________________________________________________
9. COMMENTS REGARDING COMPLIANCE WITH CONTRACT TERMS AND CONDITIONS
10. COMMENTS REGARDING ANY KNOWN PERFORMANCE DEEMED UNACCEPTABLE TO THE
CUSTOMER, OR NOT IN ACCORDANCE WITH THE CONTRACT TERMS AND CONDITIONS
11. LIST ALL MAJOR SUBCONTRACTORS THAT WORKED ON REFERENCED PROJECT, IN WHAT
TRADE, AND WHAT PERCENTAGE OF WORK DONE:
FA875126R0004
Past Performance Questionnaire
SECTION B: Past performance reference completes this entire Past Performance Questionnaire section.
INSTRUCTIONS FOR REFERENCE
You have been identified as a past performance reference for solicitation FA875126R0004 Rome Research Site- Site
Support Services at the Air Force Research Laboratory, Rome NY. In order for the Government to evaluate the past performance of the Offeror identifying you as a reference, please complete Section B of this Past Performance
Questionnaire, then return it to the Contract Specialist below. The Contract Number and Program Name provided by the Offeror are found in Block #2 below. If the Offeror performed additional contracts for your organization, please provide past performance information on those contracts as well.
Response Date: TBD
CONTRACT SPECIALIST: BROOKE MCDONALD
AFRL/RIKO
26 ELECTRONIC PKWY
ROME NY 13441-4514
TEL: (315) 330-3979
E-MAIL: Brooke.McDonald@us.af.mil
The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable. Thank you for your assistance.
1. NAME: ____________________________________________________________________
POSITION: ____________________________________________________________________
ADDRESS: ____________________________________________________________________
TEL: ___________________________ FAX: _____________________________
EMAIL: ____________________________________________________________________
2. CONTRACT #: _______________________PROGRAM NAME:___________________________
3. RELATIONSHIP AND TIME INVOLVED WITH OFFEROR:
4. WHAT, IF ANY, ELEMENTS OF WORK WERE SUBCONTRACTED? PLEASE ESTIMATE
THE PERCENTAGE OF THE TOTAL WORK THAT WAS SUBCONTRACTED?
SECTION B, CONTINUED: Please rate the offeror’s performance using the scale below.
mailto:Brooke.McDonald@us.af.mil
FA875126R0004
E G S M U N
Exceptional Good Satisfactory Marginal Unsatisfactory Neutral
Performance meets contractual requirements with many exceeded to the
Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.
Performance meets contractual requirements with some exceeded to the
Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.
Performance meets contractual requirements.
The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.
Performance does not meet some contractual requirements.
The contractual performance of the element or sub-element 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.
Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.
Performance was not observed or not applicable to the current effort being reported against.
EVALUATION AREAS
I. Technical Capability E G S M U N
1.
Contractor developed and submitted realistic approaches, plans, and performance goals.
2.
Contractor provided services that met or exceeded contract requirements.
3.
Contractor was able to troubleshoot and recommend mitigating solutions.
4.
Contractor provided effective training to
Contractor personnel.
5.
Contractor completed all efforts with good workmanship. There were minor, if any, deficiencies.
6.
Performance of services was cost effective. There were minimal cost increases to the original negotiated amount. If there were significant changes, please explain below.
7.
Contractor provided effective Quality Control and inspection procedures that resulted in a high quality service.
FA875126R0004
8.
Contractor provided satisfactory resolution to any quality issues observed during contract performance.
9.
Contractor followed their approved Quality
Control plan and instituted improvements whenever possible.
10.
Contractor performed without a trend of related deficiencies and without issuance of Corrective
Action Report(s).
Comments:
II. Timely Performance E G S M U N
1.
Contractor met established frequency requirements to complete the project on time and to ensure quality service.
2.
Contractor performed all work without the issuance of a cure notice or show cause letter. (If a notice was issued, please describe the circumstances in the comments section and identify how the situation was resolved.)
3.
Contractor provided timely proposals and responses to contract changes, if any.
4.
Contractor submitted progress schedules and interim progress reports, as required, in a timely manner.
5.
Contractor provided deliverables/submittals on time as required.
Comments:
III. Management Effectiveness E G S M U N
1.
Contractor provided experienced, qualified personnel with the technical and administrative abilities needed to meet contract requirements.
2.
Contractor hired quality subcontractors and effectively managed and coordinated their work.
3.
Contractor ensured the site Program Manager or equivalent had sufficient authority to make decisions and take actions during contract performance.
4.
Contractor paid employees/subcontractors fully and on time.
5.
Contractor cooperated to resolve problems, attended meetings, and maintained effective communication to ensure satisfactory resolution.
6.
Contractor demonstrated ability to hire and maintain qualified personnel, as well as replace personnel if necessary, during the contract period.
7.
Contractor successfully implemented a Transition
Plan, mobilizing without causing service disruption.
FA875126R0004
Comments:
IV. Contract Administration E G S M U N
1.
Contractor provided complete and correct documentation in a timely manner.
2.
Contractor was responsive during contract performance on administrative issues.
Comments:
V. Compliance with Security Standards E G S M U N
1. Adherence to DD Form 254 requirements.
2.
Adherence to security requirements specifically identified in the SOW/PWS.
3.
Adherence to policies/procedures for safeguarding classified information.
4. Adherence to Facility Security procedures.
5. Contractor demonstrated safe work habits through proper and adequate use of protective equipment and job site protection to maintain accident, injury, and damage free work zone.
6. Contractor fulfilled all safety regulations without notice, warning, work suspension, or other outside motivation.
7. Response to spills, mishaps, or other incidents was timely. Reports were made as required. Collateral risk was mitigated promptly. If no incidents for the project, please write N/A.
Comments:
VI. Overall Performance E G S M U N
FA875126R0004
1. Please rate the contractor’s overall performance.
ADDITIONAL COMMENTS (attach additional sheets as necessary):
File details come from the government source that posted it. Updated .