10. Past Performance Questionnaire.docx

Attachment 13

PAST PERFORMANCE QUESTIONNAIRE

Please complete the questionnaire and return it to the Government Contracting Officer. Please submit the completed questionnaire to one of the addresses listed no later than the last day of the RFP.

Email Address: Contract Manager (CM), Sara Ryan sara.ryan.2@us.af.mil and the Contracting Officer (CO), Tracie Holman tracie.holman@us.af.mil

SECTION I: CONTRACT IDENTIFICATION

Please complete the following information on the contract in which you are involved.

Work Sample Identifier: (e.g. WS1-WS15)

Contract Type:

(Please check one box from each column)

|_| Time and Materials |_| Other, Specify:

Period of Performance (inc. unexercised options)

Geographic location of performance

Provide a description of the service provided.

Describe your role on the contract (e.g. prime or subcontractor).

SECTION II: EVALUATION

Use the following ratings and descriptions as guidance in providing element ratings. Ratings should only reflect the performance of the contractor in question.

Note: To justify an Exceptional rating, identify multiple significant events and state how these events were of benefit to the Government. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

Note: To justify a Very Good rating, identify a significant event and state how it was a benefit to the Government. There should have been no significant weaknesses identified.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems that the Contractor recovered from without impact to the contract or order. There should have been NO significant weaknesses identified. A fundamental principle of assigning ratings is that Contractors will not be evaluated with a rating lower than Satisfactory solely for not performing beyond the requirements of the contract or order.

Note: To justify Marginal performance, identify a significant event in each category that the Contractor had trouble overcoming, and state how it impacted the Government. A Marginal rating should be supported by referencing the management tool that notified the Contractor of the contractual deficiency (e.g., management, quality, safety, or environmental deficiency report or letter).

Note: To justify an Unsatisfactory rating, identify multiple significant events in each category that the Contractor had trouble overcoming, and state how these events impacted the Government. A singular problem, however, could be of such serious magnitude that it alone constitutes an Unsatisfactory rating. An Unsatisfactory rating should be supported by referencing the management tools used to notify the Contractor of the contractual deficiencies (e.g., management, quality, safety, or environmental deficiency reports, or letters).

For each question, please place an “X” in the box corresponding to the rating.

Please rate Contractor performance in the following areas:

Please discuss all ratings except “Satisfactory” or “Neutral.” Provide a reference to the performance area number being discussed.

Government Contracts Only

1. Was the contractor ever issued a cure or show cause notice? |_|Yes |_|No If yes, please explain.

2. Was this contract partially or completely terminated for default or convenience, or are there any pending terminations?

If yes or pending, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

SECTION III: NARRATIVE SUMMARY

1. Please provide any additional comments concerning this contractor’s performance, as desired. Please discuss all ratings except “Satisfactory” or “Unsatisfactory.” Provide a reference to the performance area number being discussed.

SECTION IV: EVALUATOR IDENTIFICATION

Please provide information for the primary individuals completing this survey.

Thank you for your prompt response and assistance!