3. Past Performance Survey Form.doc
DOC document 82 KB Posted
- Attached to
- Humidifier Replacement - Minneapolis ARTCC
- Solicitation number
- 697DCK-26-R-00258
About this file
This is a Past Performance Survey Form template designed to evaluate contractor performance on previous projects. The form serves as an assessment tool for the FAA to gather information about offeror qualifications and historical project delivery for the Humidifier Replacement solicitation at Minneapolis ARTCC (Solicitation Number 697DCK-26-R-00258). As a template document, it does not contain specific evaluation criteria, scoring methodology, or substantive requirements beyond its function as a data collection instrument. Prospective offerors should expect to complete this form as part of the proposal submission package to demonstrate their past performance capabilities relevant to the estimated $250,000 to $500,000 humidifier replacement construction project scheduled for the Minneapolis Air Route Traffic Control Center in Farmington, Minnesota. Completed survey responses are due no later than noon Pacific Time on Friday, July 31, 2026, along with all other proposal materials, submitted via email to mark.salum@faa.gov with a maximum total file size of 10MB per submission.
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment 0001.pdf | ||
| 697DCK-26-R-00258.pdf | ||
| 2. Wage Determination.pdf | ||
| 1. Specifications.pdf | ||
| 1.A. Drawings.pdf |
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Text version
Past Performance Survey Federal Aviation Administration – AAQ-540
The information obtained from this questionnaire will be utilized to evaluate the past and present performance of offerors submitting proposals in response to the 697DCK-26-R-00258. The information provided will be instrumental in allowing the Government to evaluate how well the contractor performed under your contract(s).
a.
Please complete all sections of the attached questionnaire. Include your name and title, organizational address, e-mail address, telephone and fax number.
b.
Include the contractor’s name and address, the title and/or description of the type of work performed, the award number, the value of the contract (including options), the award and completion date of the project and the type of award/solicitation.
c.
Use the rating scale found on the bottom left corner of the questionnaire to rate each performance element.
d.
Comments are encouraged and would be appreciated. The last page may be used if additional space is needed for comments. Clear handwritten responses are sufficient.
Thank you for your time and participation.
FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED
PAST PERFORMANCE SURVEY
Your Name & Title yOUR Organizational Address
TEL NO.
FAX :
E-MAIL:
CONTRACTOR’S NAME & ADDRESS
TITLE OR DESCRIPTION OF REQUIREMENT:
CONTRACT NUMBER:
CONTRACT VALUE (INCLUDING OPTIONS):
CONTRACT TYPE:
FORMCHECKBOX
FIXED PRICE
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COST + FEE
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COMPETITIVE
FORMCHECKBOX
NON-COMPETITIVE
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SET-ASIDE
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SEALED BID
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NEGOTIATED
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SEALED BID
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NEGOTIATED
CONTRACT AWARD & COMPLETION DATE:
| PAST PERFORMANCE ELEMENT |
| RATING |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| NA |
1.
Contractor demonstrated a thorough understanding of technical requirements of the contract/task.
FORMCHECKBOX
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Comments:
2.
Contractor anticipated/identified and resolved problems effectively.
FORMCHECKBOX
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Comments:
3.
Contractor managed and directed resources (i.e. personnel, subcontractors, equipment, etc.) effectively.
FORMCHECKBOX
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Comments:
4.
Contractor provided the necessary skilled personnel to perform the required work.
FORMCHECKBOX
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Comments:
5.
Contractor retained the necessary skilled personnel and maintained a low turnover rate.
FORMCHECKBOX
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Comments:
FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED
CUSTOMER SATISFACTION SURVEY
6.
Contractor met scheduled contract delivery dates.
FORMCHECKBOX
FORMCHECKBOX
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Comments:
7.
Contractor provided accurate, complete and high quality deliverables.
FORMCHECKBOX
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Comments:
8.
Contractor complied with the terms of the contract.
FORMCHECKBOX
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Comments:
9.
Contractor was diligent in forecasting and controlling contract cost.
FORMCHECKBOX
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Comments:
| 10. I would recommend award to this contractor again. |
| FORMCHECKBOX |
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Comments:
| 1 |
| 0 – 25% of the time |
| Strongly Disagree |
| 2 |
| 26 – 40% of the time |
| Disagree |
| 3 |
| 41 – 55% of the time |
| Somewhat Disagree |
| 4 |
| 56 – 70% of the time |
| Somewhat Agree |
| 5 |
| 71 – 85% of the time |
| Agree |
| 6 |
| 86 – 100% of the time |
| Strongly Agree |
NA
No Knowledge of This Element
FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED
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