Past Performance Questionnaire Master.doc

Past Performance Questionnaire

This Questionnaire relates to solicitation requirements for the Kansas Army National Guard Food Service Contract at the Regional Training Institute (RTI), Salina, Kansas

PAST PERFORMANCE QUESTIONNAIRE – W912JC-13-R-0001

Your assistance is requested in support of a source selection for Food Service Contract, RTI, Salina, KS.

Please complete this Questionnaire and e-mail or send by facsimile (FAX: 785-274-1642)

USPFO for Kansas Contracting Division 2737 S. Kansas Ave.

Topeka, KS 66611-1170 ATTN: John Weber, Contracting Officer

Phone: 785-274-1335 , Fax 785-274-1642 E-mail: john.d.weber.mil@mail.mil

Desired Response Date:

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

Proposed prime contractor for Food Service Contract, RTI,

Contractor Name and Address and contract/project information being addressed in this questionnaire

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options): $

6. TYPE OF CONTRACT:

7. DESCRIPTION OF PROJECT REQUIREMENTS: (Please indicate the scope of the project being addressed in this questionnaire including the end item, i.e, provided full food service contract versus catered meals).

8. Point of Contact: Provide the following information for the company and individual completing this questionnaire:

Company/Agency Name and Address:

Name of person completing this questionnaire:

Title:

Role/responsibility for the effort being address in the survey:

Phone Number:

E-Mail:

Rating Scale:

EXCELLENT: Superior performance. Objectives/requirements essentially always achieved or exceeded, with inconsequential exceptions.

GOOD: Highly satisfactory performance. Objectives/requirements achieved with only rare exceptions, and the exceptions had minor consequences.

ADEQUATE: Generally satisfactory performance. Objectives/requirements generally achieved with occasional exceptions, and, in most cases, the exceptions had minor consequences.

MARGINAL: Occasionally unsatisfactory performance of significance. Objectives/requirements were not fully achieved, with significant consequences in some cases.

POOR: Frequently unsatisfactory performance of significance. Objectives/requirements frequently not achieved, with significant consequences.

UNKNOWN: Unable to rate, not observed, or not a significant aspect of performance.

9. Questionnaire: Please indicate the rating that best reflects your experience with this contractor and provide a short narrative addressing the basis for the ratings assigned. Address compliance with requirements, actual performance, problems encountered and problem resolution. Use additional sheets if necessary.

(1) Quality Control – Assess the contractor’s adherence to contract requirements, i.e., menu, installation processes and practices, and conformance to contract specifications and work statement. Quality of workmanship and adequacy of contract personnel.

(2) Timely Performance – Assess the contractor’s adherence to delivery commitments and serving schedules. Identification/correction of defective work work in a timely manner.

(3) Management Effectiveness – Assess the contractor’s adherence to sound quality procedures and practices. Experienced managers and supervisors with the ability to meet contract requirements.

(4) Problem Solving – Assess the contractor’s ability to identify and resolve problems effectively and in a timely manner, including correction of faulty work and early identification and correction of problems.

(5) Customer Satisfaction – Assess the contractor’s business-like concern for its customers, including such factors as dependability, flexibility, early problem identification, communication, and responsiveness.

(6) Overall Assessment: Provide your overall assessment of the contractors performance including the quality of meals and overall contract performance in providing an efficient food service operation.