Atch4-PastPerformanceQuestionnaire.doc

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FOR

SOLICITATION W564KV-12-R-0017

Dear Sir or Madam:

1. The Theater Contracting Center (TCC), Kaiserslautern, Germany is currently evaluating proposals for US Army Garrison- Stuttgart Installation Maintenance contract under RFP W564KV-12-R-0017.

2. As part of the source selection process, potential offerors’ past performance is being evaluated. The TCC would appreciate your time and effort in completing the attached questionnaire. Please return completed questionnaires to Ms. Ann Peternal-Boyle at ann.m.peternalboyle.civ@mail.mil, Mr. Sean DeHaas at sean.e.dehaas.civ@mail.mil and Mr. Peter Deibert at peter.e.deibert.civ@mail.mil no later than 3 December 2012.

3. Please use the rating system and definitions herein to complete the Past Performance Questionnaire.

4. Comment freely in the spaces below the questions or on a separate sheet of paper if necessary. Both favorable and unfavorable comments are welcome. We request comments for ratings above or below Satisfactory.

5. The time and effort in completing this questionnaire is greatly appreciated.

Thank you in advance for your assistance.

Sincerely, //S//

Peter E. Deibert

Contracting Officer

PAST PERFORMANCE ASSESSMENT QUESTIONNAIRE

Message to the respondent: This questionnaire is provided to assist the Theater Contracting Center in the past performance evaluation of offerors pertaining to a competitive acquisition that will result in the award of federal contracts. Therefore, it is important that your information be as factual, accurate and as complete as possible to preclude the need for follow-up queries by the evaluators. In an effort to expedite receipt of the requested information, the Contracting Office respectfully requests that you do not mail hard copies. Instead, please e-mail the completed questionnaire(s) to ann.m.peternalboyle.civ@mail.mil, sean.e.dehaas.civ@mail.mil and peter.e.deibert.civ@mail.mil.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Government or Non-government Contract

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

CAGE Code:

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

FAX Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

Check appropriate box and provide comments based on the following ratings/definitions.

A. Compliance with requirements in the Performance Work Statement.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

B. Adherence to contract schedules, including timely submittal of documentation and all administrative aspects of performance, required throughout contract performance

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

C. Overall effectiveness of Contract/Project Management (to include use and control of subcontractors).

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

D. Effectiveness in Forecasting and Controlling Project Cost.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

E. Ability to adapt to changes in the contract requirement.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

F. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

G. Overall Satisfaction.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

H. General Comments. Provide any other relevant performance information.

Exceptional

Very Good

Satisfactory

Marginal

Unsatisfactory

Comments:

I. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

PART III. (To be completed by Respondent)

A. RESPONDENT IDENTIFICATION

Organization:

Name:

Title:

Date:

Telephone Number

Address:

Fax Number:

E-mail Address: