Past Performance Questionnaire.docx

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION IAW 3.104

ATTACHMENT 3

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

SOLICITATION NO. FA301621U0023

FORT SAM HOUSTON LIBRARY WIFI SERVICES

The below contractor has identified you or your (Agency) company as a reference as having knowledge of or experience with the contractor’s past performance, which is reqeusted for the above reference solicitation. Please take a moment to complete this survey; your candid response(s) to this questionnaire will be of assistance in the source selection process. Therefore, it is important that the information you provide be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to a person who does.

Upon completion of the questionnaire, please return a copy to:

Please return the completed questionnaire via email to: 502 CONS/JBKAB, 1655 Selfridge Avenue, JBSA-Lackland AFB, TX 78236, Attn: SSgt Kibler, Nathaniel, Email: Nathaniel.kibler@us.af.mil no later than 4:00PM CST by 29 January 2021.

Thank you for your assistance in the Past Performance evaluation process!

SECTION 1: CONTRACT IDENTIFICATION (To be completed by the Offeror)

1. Contractor and Cage Code of contractor contract was awarded to: _______________________________________ B. Contract#: __________________ Period of Performance w/ Opt Yrs.: Start Date: _________ End Date: _________ C. Total Contract Amount (include mods and options): $_________________________________________________ D. Description of service provided: _________________________________________________________________ E. Identification of Offeror’s Representative:

F. Evaluator (Respondent) Point of Contract:

Name and Title: ______________________________________________________________________________ Organization/Agency Name: ___________________________________________________________________ Phone#_________________________ Email Address: _____________________________________________

SECTION 2: EVALUATION (To be completed by Point of Contact – Respondent)

Please complete this questionnaire based on the following guidance:

1. Handwritten responses are sufficient. Please write legibly.

1. Please discuss each and every response for which you indicated 5/E (5/Exceptional), 2/M (2/Marginal) or 1/U (1/Unsatisfactory) in response to the questions below. Space for your narrative remarks is provided in Section 3 REMARKS (use additional sheets, if necessary).

1. Indicate, based on the performance levels defined below, the contractor’s performance on the identified program. Assessments should reflect only contractor liable performance. The following is a definition of the scoring levels:

PERFORMANCE LEVELS

You are urged to supplement your own knowledge of the contractor’s performance with the judgment of others in your organization.

Please return the completed questionnaire via email to: 502 CONS/JBKAB, 1655 Selfridge Avenue, JBSA-Lackland AFB, TX 78236, Attn: SSgt Kibler, Nathaniel, Email: Nathaniel.kibler@us.af.mil

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

C1. Timeliness and accuracy of the Contractor fulfill financial responsibility for contract employees.

C2. Provide experienced managers and supervisors with technical and administrative abilities to meet contract requirements.

C3. Provide effective quality control/inspection procedures.

C4. Corrected deficiencies in a timely manner.

C5. Identifed problems as the occurred.

C6. Suggested alternative approaches to problems.

C7. Displayed initiative to problem solving.

C8. Timeliness and accuracy of Contractor responsive to contract changes.

C9. Contractor’s overall performance.

E1. Ability to hire/apply a qualified highly specialized workforce to this effort.

E2. Ability to support the program with limited staff turnover.

E3. Ability to retain incumbent staffing upon award of contract.

E4. Contractor ability to smoothly transition resources and personnel.

Has/was this contract been partially or completely terminated for default or issued a cure or show cause notice?

___Yes ____Default ____Cure ____Show Cause ___No

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

SECTION 3: REMARKS. Please provide any additional information you feel is important and not covered elsewhere.

How would you describe your organization’s experience with the contractor?

Has the contractor failed to deliver a service as part of an agreement?

Would your organization consider entering into a new business partnership with this contractor?

Would you have any reservations about soliciting this contractor in the future or having them perform one of the your critical and demanding programs?

Would you award another contract to this contractor?

Evaluator’s Printed Name/ Title

Evaluator’s Signature Date