Past Performance Assessment Questionnaire (Signed).pdf

PAST PERFORMANCE ASSESSMENT QUESTIONAIRE - COVER LETTER

02 NOV 2026 CCMI-CHD-RLC

MEMORANDUM FOR RECORD

SUBJECT: OFFEROR PAST PERFORMANCE ASSESSMENT IN SUPPORT OF

REQUEST FOR PROPOSAL (RFP) W911RX-27-R-A001

Dear Sir/Ma’am, The US Army Mission and Installation Command (MICC)- Fort Riley 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] 316210, Footwear Manufacturing. 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 no later than 30 November 2026, 12:00 PM to Kevin Jones/Contracting officer email: kevin.jones185.civ@army.mil and Contract Specialist at vernard.d.ross.civ@army.mil.

Your cooperation is greatly appreciated. Questions may be directed vernard.d.ross.civ@army.mil.

KEVIN JONES

Contracting Officer mailto:kevin.jones185.civ@army.mil mailto:vernard.d.ross.civ@army.mil mailto:vernard.d.ross.civ@army.mil

Past Performance Assessment Questionnaire

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information 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 the person who does and notify the Contracting Officer. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.

Rating Definitions:

Acceptable: Performance met contractual requirements. Work was accomplished with few, if any, problems. Any minor problems experienced were resolved with effective or highly effective corrective actions taken by the contractor. The contractor has successfully performed the required effort.

Neutral: The evaluator or respondent has no knowledge of, or past experience with, the contractor's performance regarding this specific requirement or area of evaluation; or the performance occurred outside the evaluation period.

Unacceptable: Performance did not meet some or most contractual requirements.

Serious problems with contractor performance were experienced for which the contractor either did not identify corrective actions, took corrective actions that were ineffective or only marginally effective, or the contractor has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

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

Contract Award Date:

A. CONTRACT IDENTIFICATION

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

Name:

Title:

Date:

Telephone Number:

Business Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Respondent) *Note:

rationale is required for each response.

Acceptable Neutral Unacceptable

Rationale:

Acceptable Neutral Unacceptable

B. IDENTIFICATION OF RESPONDENT

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship (to include supply chain management and equipment allocation)

B. Effectiveness of Overall Management and Organization (to include use and control of subcontractors and quality control).

Rationale:

1404239054.CIV

Highlight

Acceptable Neutral Unacceptable

Acceptable Neutral Unacceptable

Comments:

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:

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

C. Timeliness of Performance for Services and Product Deliverables.

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

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

Rationale:

Rationale:

CCMI-CHD-RLC

SUBJECT: OFFEROR PAST PERFORMANCE ASSESSMENT IN SUPPORT OF

REQUEST FOR PROPOSAL (RFP) W911RX-27-R-A001

PART III. RETURN INFORMATION

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

Thank you for your assistance.