Past Performance Questionnaire.pdf

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

Section L Attachment: Past Performance Questionnaire

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The 341st Contracting Squadron of the Air Force Global Strike Command is in the process of competitively selecting a source for a WOC Crestron System Technology Refresh.

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 calendar days after your receipt of this letter. This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to jean-denis.ducimetiere@us.af.mil and rhiannon.deforest.2@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.

1 Atch Past Performance Questionnaire

Section L Attachment: Past Performance Questionnaire

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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. Description of work performed:

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

K. 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):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

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

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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 questions below, indicate your rating for the contractor’s performance by checking the appropriate box under 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.

A. TECHNICAL FACTOR – Rate the Offeror’s performance for the following subfactors:

1. Subfactor – Relevancy and Scope

Did the contractor perform an Audio/Visual (AV) system tech refresh, migration, or upgrade of similar scale and technical complexity to an operations center environment? (Identify any waivers/deviations that were required.)

☐ E ☐ V ☐ S ☐ M ☐ U ☐ N/A

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SUPPORTING INFORMATION:

2. Subfactor –Technical Execution & Quality

a. How would you rate the contractor's ability to seamlessly integrate new AV infrastructure (e.g., video routing, display systems, audio controls) and ensure interoperability with your existing secure networks or legacy baselines?

b. How would you rate the overall quality, reliability, and functionality of the delivered AV system upon completion of the project?

3. Schedule & Mission Disruption

a. How effectively did the contractor manage the tear-down and installation phases to minimize system downtime and prevent disruption to ongoing mission operations?

b. How successfully did the contractor adhere to the agreed-upon project schedule, including meeting critical milestones for hardware delivery and final system commissioning?

Overall Assessment

a. Based on this contractor's overall performance, would you award another contract to them for a similar mission-critical AV tech refresh? (Yes / No - If No, please explain)

Section L Attachment: Past Performance Questionnaire

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SUPPORTING INFORMATION:

Please provide the following information regarding cost/price:

(1) Original Contract Cost/Price $

(2) Value of Negotiated Contract Changes $

(3) Actual/Projected Cost to Complete $

(4) Baseline Estimate at Completion $

(5) Total Negotiated Changes EAC $

(6) Cost Under run/Over run (-) $

REMARKS:

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).

C. GENERAL COMMENT (Choose one of the following and explain your choice in the remarks)

Given what I know today about the contractor’s ability to execute what they promised in their proposal, I award to him today given that I had a choice.

REMARKS:

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

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E-Mail to: