16 Attachment 4_Past Performance Questionnaire.doc

ATTACHMENT #4

PAST PERFORMANCE QUESTONAIRE

Control Number: 6973GH-23-R-00198

TO BE COMPLETED BY THE OFFEROR:

I. CONTRACT INFORMATION –

1. This questionnaire relates to work performed by (Name of Contractor/Company/Division)

2. Contract Number: ________________________________________________________

3. Contract type: ___________________________________________________________

4. Contract Total Value: $____________________________________________________

5. Contract start-completion dates: ____________________________________________

6. Description of Work performed: _____________________________________________

TO BE COMPLETED BY THE EVALUATOR:

The Department of Transportation, Federal Aviation Administration is interested in your assessment of the named company’s performance on your contract for the purpose of utilizing this information to evaluate the contractor’s probability of successfully performing a federal government requirement that is currently being advertised. Please complete and submit no later than 4:00 pm CST on 20 October 2023.

Is the information provided above in questions 1-6 accurate and correct to the best of your knowledge?

Yes______ No_____

If “No” why not?

II. PAST PERFORMANCE EVALUATION

Please rate the Contractor as “Highly Acceptable” (H), “Acceptable” (A), and “Unsatisfactory” (U):

A. QUALITY OF PRODUCT OR SERVICES

1. Compliance with contract terms and conditions.

Rating: ________

PAST PERFORMANCE QUESTIONAIRE (CONTINUED)

2. Quality of services and support provided including content and accuracy of technical, cost, or other reports.

Rating: ______

B. TIMELINESS OF PERFORMANCE

Timely completion of deliverables and/or milestones on tasks.

Rating: ___________

C. COST CONTROL

1. Adherence to target costs on the contract level and at the task level.

2. Cost overrun and change proposals submitted were reasonably priced and contained all appropriate supporting documentation.

D. BUSINESS PRACTICES

1. Contractor’s skills in efficiently and effectively allocating and directing personnel and resources to meet customer needs.

2. Contractor’s reasonable and cooperative behavior, flexibility, as well as their responsiveness to inquiries from your organization’s technical and contract representatives.

E. CUSTOMER SATISFACTION

1. Were there any significant problems encountered by the Contractor? Yes____ No____

If yes, state the problem(s), what corrective actions were taken by the Contractor, and indicate whether you consider these corrective actions to be effective?

2. Please comment on the overall satisfaction of your organization with the contractor’s performance.

3. Additional comments both positive and negative (please address any unfavorable ratings identified from Part II above).

III. RESPONDENT INFORMATION

1. Name of Evaluator(s): _________________________________________

2. Position Title(s): ______________________________________________

3. Organization Name and Mailing Address:

4. Telephone Number: _______________ Fax Number: __________________

5. Email Address: ________________________________________________

6. Date Questionnaire Completed: ___________________________________

Please return the questionnaire by email as follows:

Email: jason.m.perry@faa.gov

*NOTE: if emailing, please make Subject of

SURVEY RESPONSE: 6973GH-23-R-00198

For questions, please contact Mr. Perry at (405) 954-3141

THANK YOU FOR YOUR TIME IN COMPLETING THIS QUESTIONNAIRE

SOURCE SELECTION SENSITIVE INFORMATION