Attachment 3 - ATAC Past Performance Survey.docx

HTC711-10-R-R004

ATTACHMENT 3

PAST PERFORMANCE SURVEY

When Filled In This Document Is Source Selection Sensitive Information IAW FAR 2.101 & 3.104

A. GENERAL INFORMATION: (To be completed by Offeror)

Contractor’s Name: _________________________________________________________

Address:______________________________________________________________________________________

Telephone Number: _____________________________________________________________________________

Email: _______________________________________________________________________________________

Point of Contact: ______________________________________________________________________________

Project Title and Brief but Detailed Description of Work (including workload estimates):

Contract Number : ____________________________________

Contract Value (Base & Option Years): $

Place of Performance: ________________________________________________

Period of Performance: ________________________________________________

Contractor Performed as the Prime Contractor Sub-Contractor.

B. RESPONDENT INFORMATION (To be completed by Respondent):

Name of Respondent: _______________________________Title:________________________________

Address: _____________________________________________________________

Telephone Number:

Fax Number:__________________________ Email Address:

Note: If any of the information in Section A is incorrect, please make necessary changes. Also, if offeror holds or has held other relevant contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

C. FAX OR E-MAIL COMPLETED SURVEY FORM TO:

Please email the completed survey to the below address no later than: 19 July 2010 /4:00 PM CT to:

Email: belfield.collymore@ustranscom.mil Email: david.stevens@ustranscom.mil

Direct survey completion questions/comments to the above address/individual(s)

NOTE: PPIRS may be reviewed. Although you may have filed a Contractor Performance Assessment Report (CPARS) for the contract listed, we would appreciate your response to this survey because some of the questions relate to areas not covered by CPARS and are specifically related to this acquisition.

D. QUALITATIVE INFORMATION:

1. Describe the contractor’s efforts at consolidating various shipments to multiple locations while taking into account varying transit time requirements.

1. Did the contractor provide air shipment service? Yes/No If Yes, were any of those shipments to Hawaii?

1. Did the contractor provide Intransit Visibility (ITV)? Yes/No If Yes, how was this service provided?

1. Describe the contractor’s ability to perform on-call and daily delivery service in multiple locations throughout the United States?

1. Did the contractor provide service to Canada? Yes/No If Yes, describe the type of service provided and your level of satisfaction with that service.

1. Did the Contractor provide proof of Delivery and Proof of Shipment service? Yes/No How was this service provided?

E. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

THE CONTRACTOR:

GENERAL:

REMARKS

PLEASE PROVIDE A PARAGRAPH SUPPORTING YOUR ABOVE RATINGS. EXPLAIN THE CONTRACTOR’S GREATEST STRENGTHS AND/OR WEAKNESSES AND YOUR RATIONALE FOR WHY YOU WOULD OR WOULD NOT AWARD A FUTURE CONTRACT TO THEM.

Survey Respondent’s Signature Date

Thank you for your prompt response and assistance!