Attachment III - Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

FT. HOOD GOCO FUELING SERVICES

SOLICITATION SPE603-26-R-0519, SECTION J

ATTACHMENT III

SOLICITATION SPE603-26-R-0519

CONTRACT PERFORMANCE ASSESSMENT FORM

GENERAL INFORMATION (Offeror to complete this portion)
Name of Company or Organization doing business with Contractor (Customer/Client)

Customer Point of Contact/Email Address

Phone Number

Original Contract Price

Name of Contractor

Contract Number

Period of Performance

Worked Performed as:

Complexity of Work

Contract Dates

Contract Type

❑
❑
❑

Firm Fixed Price
Cost Reimbursement
Other

Prime Contractor
Sub-Contractor
Prime Name:
❑
❑

❑

❑
❑
❑

High
Medium
Low

Joint Venture

Brief Description of work/supplies furnished to Customer

CLIENT INFORMATION (Reference to complete this portion) Name of Person Completing Questionnaire

Title

Email Address

Client’s Signature and Date

PLEASE RETURN THIS FORM WITH THE COMPLETED QUESTIONNAIRE TO:

Alexandro Cano @ Alexandro.Cano.dla.mil ; Rhoji Fernandez @ [email protected]

CUI

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

GENERAL GUIDANCE FOR COMPLETING QUESTIONNAIRE

A. The questionnaire should be completed by the individual most knowledgeable of the Contractor’s day-to-day operations and overall condition of service being rendered. However, that individual is encouraged to supplement their own knowledge of the Contractor’s performance with the judgment of others in their organization, as applicable.
B. Legible handwritten responses are sufficient.
C. Please provide explanatory narratives for as many responses as possible. These narratives need not be lengthy, just descriptive. Space for narrative comments is included after each question and on the last page of the survey. If more space is needed, use the back of the survey or attach additional pages. D. As the survey relates to an ongoing source selection for the services identified in the cover letter, request that all information provided within the survey be safeguarded against unauthorized disclosure. E. The following description should be used as a guide in providing element ratings:

EXCEPTIONAL

Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed 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