I.B.1.__Comb_S-S_Atch_04_Past_Perf_Questionnaire_Amended_01_Mar_16_Letter.pdf

DEPARTMENT OF THE ARMY

U.S. ARMY MISSION AND INSTALLATION CONTRACTING COMMAND

MICC-FORT SAM HOUSTON

2205 INFANTRY POST ROAD

JBSA FORT SAM HOUSTON, TX 78234-1361

1 Mar 2016

CCMI-FSH

Dear Sir or Madam, The United States Army, Office of the Assistant Chief of Staff, Installation Management (OACSIM) is acquiring

Technical Engineering and Professional Services to assist in fulfilling its mission.

The OACSIM is the Army Staff proponent for installation, facilities, and environment and the principal military advisor to the Assistant Secretary of the Army for Installations, Energy and Environment. OACSIM’s tasks include management of environmental and occupational health on installation readiness and family programs, development of strategic policies, and establishment of priorities, resources, strategy and program guidance related to the management and resourcing of all Army facilities and installation.

The objective of this requirement is to provide OACSIM Technical Engineering and Professional Services in support of the Army Housing Program. Services to be provided in this contract will be (but are not limited to) conducting feasibility studies, assistance in the preparation of various housing reports and budgetary/financial documents, inspection services of Army housing facilities and independent Government housing analysis efforts.

The U.S. Army is conducting a performance confidence assessment in anticipation of a possible contract award.

An offeror interested in proposing on this work has identified you as a Point of Contact on a past or present contract which the offeror deems relevant to this effort. We are therefore requesting your assistance in completing the attached Past Performance Assessment Questionnaire so that we may evaluate the offeror under the factor of past performance. The Questionnaire has been developed for ease of electronic completion. Please provide your comments regarding the overall assessment of the offeror’s performance on the contract identified and any additional information that your organization deems relevant to our evaluation team. It is important that your information be as factual, accurate, and complete as possible to preclude the need for follow-up by the evaluators.

Please complete and submit the Questionnaire within 3 days of receipt via e-mail to the following individuals:

Mr. Michael Bilicki, Contract Specialist, e-mail: michael.t.bilicki.civ@mail.mil, and Ms. Angelic Hatcher, Contracting Officer, e-mail: angelic.m.hatcher.civ@mail.mil. Please don’t hesitate to contact either of us if you have any questions.

Thank you in advance for your assistance.

Sincerely, ANGELIC M. HATCHER

Contracting Officer mailto:michael.t.bilicki.civ@mail.mil mailto:angelic.m.hatcher.civ@mail.mil

G-3

Attachment 04

W9124J-16-R-TEPS

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

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 name cited above): Contract

Award Date:

Forecasted or Actual Contract Completion Date: Nature of the Contractual Effort or Items Purchased:

Name: Title:

Date:

Telephone Number: Address:

Email Address:

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

Outstanding (Explanation must be provided in Comments field below)

Good

Acceptable

Marginal (Explanation must be provided in Comments field below)

Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

A. CONTRACT IDENTIFICATION

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification

Requirements and Standards of Good Workmanship

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

Acceptable

Acceptable

Acceptable

Acceptable

C. Timeliness of Performance for Services and Product Deliverables.

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost

Reimbursement Type Contracts Only).

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

Interest

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:

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 identified in the cover letter.

Thank you for your assistance.

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

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

H. Respondent Identification. Please provide the following information: