Past Performance Questionnaire.pdf

For Official Use Only When completed, this document is Source Selection Information IAW RFO 2.101 and 3.104.

Section L Attachment: Past Performance Questionnaire – Joint Base Operation Center SVTC

For Official Use Only Page 1 of 5

The 87th Contracting Squadron of the Air Force Air Mobility Command is in the process of competitively selecting a source for a Secure/Non-Secure Video Teleconference System. Contractor shall replace Atlona A/V equipment with equipment compliant with Security Technical Implementation Guides (STIGs) and interoperability requirements as prescribed in DOD Instruction 8100.04. The new equipment will integrate with existing government furnished property to support both a Nonsecure Video Teleconferencing System (NVTC) and Secure Video Teleconferencing System (SVTC).

One of the considerations in proposal evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your written response no later than 10 April 2026 by 10:00 am EST.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to Mr. Noah Whiting, contract specialist, at noah.whiting.1@us.af.mil and Lizbette Zalybniuk, contracting officer, at Lizbette.Zalybniuk.1@us.af.mil. Your completed questionnaire will become a part of the official Source Selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

Questionnaire will only be accepted from the respondent not potential contractors.

LIZBETTE ZALYBNIUK

Contracting Officer

1 Atch Past Performance Questionnaire http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5836 mailto:noah.whiting.1@us.af.mil

When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Section L Attachment: Past Performance Questionnaire – Joint Base Operation Center SVTC

For Official Use Only Page 2 of 5

Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? ☐ Yes ☐ No

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract (i.e., local, nationwide, worldwide, other Commands):

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602

Section L Attachment: Past Performance Questionnaire – Joint Base Operation Center SVTC

For Official Use Only Page 3 of 5

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / fax number / e-mail address:

D. Respondent’s position (e.g., Program Manager, PCO/ACO, etc.):

E. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

F. Other suggested points of contact:

Section 4: Performance Information

In the tables below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the

Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

Section L Attachment: Past Performance Questionnaire – Joint Base Operation Center SVTC

For Official Use Only Page 4 of 5

Technical Performance E V S M U N/A

1. How well did the contractor meet the technical requirements of the contract?

SUPPORTING INFORMATION:

2. Did the contractor complete VTC installations and configurations according to schedule and technical specifications?

SUPPORTING INFORMATION:

3. Did the contractor demonstrate proficiency with the specific VTC platforms used (e.g., Cisco, Poly)?

SUPPORTING INFORMATION:

4. Did the contractor ensure VTC systems remained compliant with Air Force cybersecurity requirements (STIGs, patching, accreditation)?

SUPPORTING INFORMATION:

5. How well did the contractor integrate VTC systems with existing AF network infrastructure?

SUPPORTING INFORMATION:

6. How well did the contractor implement current standard practices for computer software design, operation, maintenance, upgrades and configuration control?

SUPPORTING INFORMATION:

7. How adequate/effective were the contractor’s environmental safety procedures?

SUPPORTING INFORMATION:

Section L Attachment: Past Performance Questionnaire – Joint Base Operation Center SVTC

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8. Did the contractor provide accurate and complete documentation (diagrams, configuration files, SOPs)?

SUPPORTING INFORMATION:

9. Were there any significant risks, incidents, or outages attributable to contractor performance?

SUPPORTING INFORMATION:

10. Would you award another VTC support contract to this contractor? Why or why not?

SUPPORTING INFORMATION:

Government Contracts Only: Was this contract partially or completely terminated for default or convenience, or are there any pending terminations?

☐ Yes ☐ Default ☐ Convenience ☐ Pending Terminations ☐ No

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

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Questionnaire will only be accepted from the respondent not potential contractors.

Please return this completed questionnaire to:

E-Mail to: Mr. Noah Whiting Noah.Whiting.1@us.af.mil Mrs. Lizbette Zalybniuk Lizbette.Zalybniuk.1@us.af.mil http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_602 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5836 mailto:Noah.Whiting.1@us.af.mil mailto:Lizbette.Zalybniuk.1@us.af.mil