Attachment 7 Past Performance Questionnaire.pdf

ATTACHMENT

ATTACHMENT 7, PAST PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS TO THE REFERENCE

FOR COMPLETING THE PAST PERFORMANCE QUESTIONNAIRE

Handwritten completion of this questionnaire is acceptable, if legible.

Include evaluation of contractor's performance based solely on the performance for which the contractor was/is liable. Please do not let factors beyond the control of the contractor which have resulted in performance delays or other problems bias the evaluation of the contractor's performance.

The following is a definition of the scoring system used:

5: Performance meets contractual requirements and exceeds many to the Owner’s benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

4: Performance meets contractual requirements and exceeds some to the Owner’s benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

3: Performance meets contractual requirements. The contractual performance of the area being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

2: Performance does not meet some contractual requirements. The contractual performance of the element being assessed evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

1: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

0: Contractor performance was terminated. Requires explanation.

In completing the questionnaire please circle a number corresponding to your rating, or "N/A" if you are unable to provide an evaluation for any area.

Please provide clear and concise narrative explanations (both positive and negative) for your answers. This is especially important for any rating above or below “satisfactory”. If more space is needed than is provided, you may attach additional sheets.

Gib Park

AAQ-721

gilbert.n.park@faa.gov

PAST PERFORMANCE QUESTIONNAIRE

(To be completed by the Referenced POC with the Offeror’s Business and Project Information)

I. CONTRACTOR/CONTRACT IDENTIFICATION.

A. Contractor (Company/Division):

B. Contract Number/Identification:

C. Contract Title (Brief Description of Work and Location):

D. Contract Type: Fixed-Price, Cost-Reimbursement;

E. Owner: Federal / State / Local Government or Private/Commercial:

F. Period of Performance:

G. Original Dollar Amount of Contract:

H. Number of Modifications:

I. Dollar Amount at Completion (or current amount, if not complete):

II. PAST PERFORMANCE/QUALITY EVALUATION:

1. Quality of Product or Service - Assess the contractor’s conformance to contract requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards): 5 4 3 2 1 0 Comments:

2. Schedule - Assess the timeliness of the contractor against the completion of the contract, task orders, milestones, delivery schedules, administrative requirements (e.g., efforts that contribute to or effect the schedule variance): 5 4 3 2 1 0 Comments:

3. Cost Control (Not applicable if the referenced contract was firm fixed price) - Assess the contractor’s effectiveness in forecasting, managing and controlling contract cost:

5 4 3 2 1 0 Comments:

4. Business Relationships - Assess the integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness and quality of problem identification, corrective actions plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior, customer satisfaction, and the timely award and management of subcontracts. Additionally, please comment as to whether the contractor met small/small disadvantaged and women-owned business participation goals:

5 4 3 2 1 0 Comments:

5. Competence of Technical Staff – Assess the technical capabilities of the contractor’s staff. Were technical solutions to your environmental problems developed that saved you time and money? Were you involved by the contractor in the technical planning of projects? Were the contractor’s ideas repeatedly rejected or significantly modified by regulatory agencies? Were innovative technologies used?

5 4 3 2 1 0 Comments:

6. If you had a choice, would you use this company again? Yes No Explain:

7. Other contacts who may be able to furnish past performance information:

RESPONDENT INFORMATION

[DO NOT RELEASE OUTSIDE OF THE GOVERNMENT – SOURCE SELECTION SENSITIVE

DATA]

A. NAME OF EVALUATOR:

B. TITLE:

C. TELEPHONE NUMBER: E-MAIL ADDRESS:

D. COMPANY/ORGANIZATION:

E. POSITION HELD IN REFERENCE TO THE CONTRACT

(TECHNICAL INSPECTOR, CONTRACT ADMINISTRATOR, ETC.):

F. LENGTH OF INVOLVEMENT IN CONTRACT:

G. WAS THE OFFEROR GIVEN THE OPPORTUNITY TO RESPOND TO ALL

ADVERSE PAST PERFORMANCE INFORMATION? Yes No Not Applicable Unknown Explain:

H. DATE QUESTIONNAIRE COMPLETED/INFORMATION PROVIDED:

I. IF THE INFORMATION WAS SUBMITTED IN WRITING, THE SIGNATURE OF THE

RESPONDENT:

Signature Date