Past Performance Survey.doc

Attachment 4 Past Performance Survey

DTFAEN-15-RFQ-IAD PAPI

Precast and Install Concrete Foundations

Service For the RW 1C Precision

Approach Path Indicator (PAPI) system at Dulles International Airport in Chantilly, Virginia

PAST PERFORMANCE SURVEY

Solicitation DTFAEN-15-RFQ-IAD PAPI

PRECAST & INSTALL CONCRETE FOUNDATION SERVICE

IAD PAPI DULLES AIRPORT, CHANTILLY, VA

To: ____________________ (Point of Contact)

____________________ (Company)

____________________ (Phone)

____________________ (Fax)

The Federal Aviation Administration is currently evaluating __________________________ and you were listed you as a performance reference. It would be greatly appreciated if you would take 5 or 10 minutes to complete the following information and return to me via fax by August 3, 2015 Fax 540-349-7602.

If you have any questions or comments, feel free to contact me. Thank you in advance for your assistance.

Charlie Peppers DOT FAA Potomac TRACON

3699 Macintosh Drive

Warrenton, Virginia 20187

540-349-7417

Please identify the project(s) that this company has performed for your organization, description, city, state, and approximate dollar value:

Respond to the following on a scale of 1 to 5, with 3 being Acceptable, and 5 being Outstanding.

1.

Did the contractor commit adequate resources in timely fashion to the contract to meet the requirements and to successfully solve problems?

1( 2( 3( 4( 5(

2.

To what extent did the contractor respond positively and promptly to technical direction, contract change orders, etc.?

1( 2( 3( 4( 5(

3. How reliably did the contractor follow through on commitments?

PAST PERFORMANCE SURVEY

Solicitation DTFAEN-15-RFQ-IAD PAPI

PRECAST & INSTALL CONCRETE FOUNDATION SERVICE

IAD PAPI DULLES AIRPORT, CHANTILLY, VA

4.

To what extent did the contractor’s management system provide visibility into problems and risks?

5.

How responsive do you think the contractor was to information requests, issues, or problems during the course of the contract?

6. How effective has the contractor been in identifying user requirements?

7.

To what extent did the contractor have the ability to administer and manage the contract?

8. To what extent did the contractor issue professional correspondence?

9.

How well did the contractor adhere to the Statement of Work?

1( 2( 3( 4( 5( 10.

What was your level of satisfaction with the contractor’s management and support staff?

11.

What was your level of satisfaction with the contractor’s Supervisor(s)?

12.

To what extent did the contractor submit required reports and documentation in a timely manner?

1( 2( 3( 4( 5( 13.

To what extent were the contractor’s reports and documentation accurate and complete?

14.

To what extent was the contractor’s maintenance and problem tracking/reporting documentation timely, accurate and of appropriate content?

15.

To what extent did the contractor comply with safety requirements?

16.

What was your level of satisfaction with the contractor’s overall quality of service?

Solicitation DTFAEN-15-RFQ-IAD PAPI

PRECAST & INSTALL CONCRETE FOUNDATION SERVICE

IAD PAPI DULLES AIRPORT, CHANTILLY, VA

17.

To what extent was the contractor effective in interfacing with the Government staff?

18.

What was your level of overall customer satisfaction?

1( 2( 3( 4( 5( 19.

To what extent were the contractor’s employees experienced and qualified?

Respond: Yes or No.

20.

Were there any cure notices issued?

Yes: ____ No: ____

21.

Was contractor pro-active?

Yes: ____ No: ____

22.

Did contractor suggest cost-saving changes?

Yes: ____ No: ____

23.

Would you recommend this contractor?

Yes: ____ No: ____

For Federal contracts:

24.

Were there any Labor Department Investigations?

Yes: ____ No: ____

24a.

If yes, please describe reason and final outcome.

25.

Were there any safety investigations?

Yes: ____ No: ____

25a.

If yes, please describe reason and final outcome.

26.

Were there any security investigations?

Yes: ____ No: ____

26a.

If yes, please describe reason and final outcome.

27. Was there a partial or complete termination for default or convenience?

Yes: ____ No: ____

Solicitation DTFAEN-15-RFQ-IAD PAPI

PRECAST & INSTALL CONCRETE FOUNDATION SERVICE

IAD PAPI DULLES AIRPORT, CHANTILLY, VA

27a.

If yes, please describe reason and final outcome.

28.

Are there any pending terminations?

Yes: ____ No: ____

29.

What is/was the duration of the contract? _____________________

30.

Were there any performance issues regarding the contractor’s work? If yes, please describe.

Please provide other comments:

Signature: ____________________________

Date: ____________________________ (c:\030000 PHX\Past Perf Survey)