Past Performance Questionnaire- FA301621U0194 RAN Library Wi-Fi.pdf

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION IAW 3.104

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

SOLICITATION NO. FA301621U0194

JBSA Randolph Library WI-FI 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 requested 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:

502 CONS/JBKAB, 1655 Selfridge Avenue, JBSA-Lackland AFB, TX 78236, Attn: Ms. Keisha Dawkins, email keisha.dawkins.2@us.af.mil not later than 4:00PM Central by 31 AUG 2021.

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

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

A. 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:

Name: _______________________________________________________________________________

Title: _______________________________________________________________________________

Date: _______________________________________________________________________________

Phone No.: __________________________________________________________________________

E-Mail Address: ______________________________________________________________________

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:

A. Handwritten responses are sufficient. Please write legibly.

B. 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).

C. 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

1 2 3 4 5 Unsatisfactory Marginal Satisfactory Very Good Exceptional

Performance does not meet most contractual requirements and recovery is not likely in a timely manner.

The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element 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.

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Performance meets contractual requirements with some exceeded to the Government’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

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 to: 502 CONS/JBKAB, 1655 Selfridge Avenue, JBSA-Lackland AFB, TX 78236, Attn: Ms. Keisha Dawkins, Teleworking, email keisha.dawkins@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:

Contractor’s Performance 5 4 3 2 1 N/A

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. Identified 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.

Employee Retention/Attraction 5 4 3 2 1 N/A

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