Questionnaire.docx

Dear Sir or Madam:

The Arkansas Army National Guard, United States Property and Fiscal Office is soliciting a contract for Brass Deformation Services. These services are to support the primary mission of the Arkansas Army National Guard on Camp Joseph T. Robinson in North Little Rock, Arkansas. The contractor will be required to staff and provide brass deformation services for the Arkansas Army National Guard..

The Army National Guard is conducting a performance confidence assessment in anticipation of a possible contract award. The 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. They are providing the Questionnaire to you. We are 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 or FAX to the Contracting Specialist identified on the Questionnaire. If you have any questions relative to the enclosed Questionnaire, please contact the Contract Specialist identified in the questionnaire.

Thank you in advance for your assistance.

Sincerely, EDWARD L. PORTER

Contracting Officer

Please note: In accordance with the Federal Acquisition Regulation Part 15.506, the names of individuals providing reference information about an offeror’s past performance shall not be disclosed.

Please complete and return Questionnaire to the Contract Specialist below:

Edward L. Porter Contracting Officer USP&FO Purchasing & Contracting Box 003, Building 7100 Camp Joseph T. Robinson North Little Rock, Arkansas 72119-9600

Phone: 501-212-4401

Email: edward.l.porter.civ@mail.mil Fax: 501-212-4359

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Brass Deformation Services, Solicitation number W912JF-16-R-0004

Contractor:____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________ POC:________________________ Title:________________________ (Name) (E.G. Contracting Officer/Contracting Officers Representative/Project Manager/ Program Manager/Contracts Manager/ Operations Manager/ Sales Manager/Business Manager) (Agency or Company 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 adjectival ratings shall be used in your response.

Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.

Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

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. (A &B To be completed by the Offeror, information is for the effort being rated by the respondent) A. CONTRACT IDENTIFICATION (effort being rated)

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:

Description of the Contractual Effort (include total dollar value):

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/Rater)

A. Compliance of Services, Documents, and Related Deliverables to Contract Requirements and Standards of Good Workmanship

*Mark applicable Ratings Block

Good

Acceptable

Comments:

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

*Mark applicable rating Block

Good

Acceptable

C. Timeliness of Performance for Services and Product Deliverables.

Good

Acceptable

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

Good

Acceptable

E. How well does the contractor comply with Subcontracting Plan Goals in the current contract (only applies if the contractor is not a small business concern and is required to submit a Small Business Subcontracting Report in accordance with FAR Clause 52.219-9)

Not Applicable

Good

Acceptable

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

F. 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:

G. Respondent/Rater Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

Please indicate your business relationship with the offeror if you are not a government employee or activity. Address if your response is completed independently in your past performance assessment of the offerors work you are rating: _______________________________________________________

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the government Contracting Specialist identified in the cover letter. edward.l.porter.civ@mail.mil

Thank you for your assistance.