5._Attachment_2._Past_Performance_Questionnaire.doc

PAST PERFORMANCE QUESTIONNAIRE

Fleet Logistics Center (FLC) Naples is currently evaluating competitive offers for the services described herein. You have been named as a point of contact for services previously provided by the contractor cited herein. Please provide the information requested in the questionnaire. The information you provide will become part of the source selection documentation; however, your name will not be released to any of the parties. Should you have any questions concerning this request, please contact Mrs. Paola Mozzillo in Naples Italy at Tel 0039 081-568-4103 or Fax 0039 081-568-4069 or E-mail at Paola.Mozzillo.IT@eu.navy.mil (To be completed by NAVSUP FLC SIGONELLA NAPLES)

Contractor:

Address:

(To be completed by person to whom questionnaire is addressed):

1.

Background Information a.

Name of person completing this questionnaire and position.

Name:

Agency:

Tel No.

E-mail Address:

E-mail Address:

b.

Contract No: ___________________________ c.

Detailed description of services:__________________________________________________ d.

Period of Performance (all years): ____________________________________ e.

Total value of the contract (all years): _________________________________

2.

Contractor's Past Performance

a. In your opinion, is the work performed under your contract similar in scope, magnitude of effort and complexity as the work described below:

The Contractor will be required to provide Liquid Petroleum Gas (LPG) for the following locations: NSA Housing at Support Site, Gricignano di Aversa (CE), Italy and NAVFAC, Naples and Gaeta, Italy.

b. Please circle a rating in answer to each of the following questions and provide comments as appropriate.

1.

How would you rate the quality of services received?

Acceptable

Unacceptable

Comments:

2.

How would you rate the timeliness of the services received?

Comments: ________________________________________________________________

3.

How would you rate customer satisfaction?

4.

To what extent did the contractor’s performance conform to the terms and conditions of the contract/employment?

5.

To what extent was the contractor reasonable and cooperative during performance (including cooperating with successor contractor)?

Comments: _______________________________________________________________

Other comments:

Acceptable:

Based on the offeror’s performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror’s performance record is unknown.

Unacceptable:

Based on the offeror’s performance record, the Government has no reasonable expectation that the offeror will be able to successfully perform the required effort.

Additional Comments: