Attachment 4 - Past Performance Evaluation Questionaire v2 UPDATED.docx

DEPARTMENT OF THE ARMY

U.S. ARMY MISSION AND INSTALLATION CONTRACTING COMMAND MISSION AND INSTALLATION CONTRACTING COMMAND-FT. HOOD

36000 SHOEMAKER LANE FORT HOOD, TX 76522-5095

CCMI-CHD-HD 2026

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) W91151-26-R-A004

Dear Sir/Ma’am, The US Army Mission and Installation Contracting Command (MICC) – Fort Hood is currently conducting a competitive source selection to evaluate offerors on the subject RFP. As part of this evaluation, we have requested that the offerors provide information about their past performance on recent and relevant federal, state, or local government or commercial contracts as compared to the North American Industry Classification System [NAICS] 561720. You have been identified as the point of contact cited on the enclosure.

Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return to the Mission and Installation Contracting Command (MICC) – Fort Hood, Shoemaker Center, 36000 Shoemaker Lane, Room 1300B, Fort Hood, Texas 76544-5095, no later than the solicitation closing date. Your questionnaire may be submitted electronically to 30 September 2026.

Your cooperation is greatly appreciated.

Questions may be directed to the Contract Specialist, Robert Sanchez at robert.l.sanchez3.civ@army.mil or the undersigned at justin.j.mansfield.mil@army.mil

Sincerely, MSG Justin J. Mansfield Contracting Officer

APPENDIX D

Performance Assessment Questionnaire

Contractor:____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________

(Agency, Telephone No., E-mail Address & Fax Number)

The following questions pertain to the contractor’s record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following ratings shall be used in your response.

Exceptional: Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory: 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 appear or were satisfactory.

Marginal: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory: 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.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

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

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:

Address:

E-mail Address:

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

A. Quality of Service

· Exceptional (Explanation must be provided in Comments field below)

· Very Good (Explanation must be provided in Comments field below)

· Satisfactory

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Satisfactory

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

C. Schedule/Timeliness of Performance for Services.

· Satisfactory

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).

· Satisfactory

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

E. Customer Satisfaction

· Satisfactory

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

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

G. 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:

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contracting Officer and Contract Specialist identified in the cover letter.

Thank you for your assistance.

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