Past Performance Survey.pdf

PROCUREMENT SENSITIVE WHEN COMPLETED

FOR OFFICIAL USE ONLY

SIR/RFO No. 6973GH-22-R-00075 PTS Fire Suppression System

PAST PERFORMANCE SURVEY

Attachment 10

To: _______________________________________________________________________ NAME Title

Organization:_____________________________________________________________

Fax No.: _________________________ E-mail Address:_________________________

Phone No.:________________________

Date: __________________________ Number of Pages (including this sheet): 5 in total

Your name was provided as a point of contact for the following:

Contractor Name:_______________________________________________________

Contract Number: _______________________________

Project Title: ___________________________________________________________

In regard to the above contractor’s performance on the referenced contract, please complete the attached Past Performance Survey and return as follows:

Send to: Raymond Lena, Contracting Officer

E-mail Address: Raymond.Lena@faa.gov

For questions, please contact me at telephone 405-954-7805.

Please provide your response no later than May 24, 2022 2:00 p.m. Central

Thank you!

SIR/RFO No. 6973GH-22-R-00075

PTS Fire Suppression System

PAST PERFORMANCE SURVEY

Attachment 10

Offeror to complete this page:

1. Name of Contractor: ____________________________________________________

2. Provide a brief description of the renovation project and how it is relevant to the HQB Building Lobby Remodel; e.g., multi-story office, single story office building, hospital, school, warehouse, square footage?

3. Type of contract; e.g., firm fixed-price, cost-reimbursable: __________________________________________

4. Contractor Role (circle one): Prime Contractor, Mechanical Subcontractor, Electrical Subcontractor

5. Contract Number (if applicable): _______________________________________________

6. Total Contract Amount - Original contract amount: $____________ Final Contract Amount: $_____________

Provide rationale for the difference________________________________________________________

7. Date of Contract Award: ______________________________________________________

8. Contract Period of Performance: Start Complete _________________

9. Was project completion date consistent with the contract completion date? ___________ If no, explain why___________________________________________________________________________________.

10. Was a deficiency notice issued? ___________ If so, was the issue successfully resolved? ___________

11. Was a Cure Notice issued? _____________ If so, was the issue successfully resolved? _____________

12. Was a Show Cause issued? _____________ If so, was the issue successfully resolved? _____________

Name of Responding Point of Contact: _____________________________________________________

Agency/Organization: _________________________________________________________________

Mailing Address: __________________________________________________________

Telephone Number: __________________________________

E-mail Address: __________________________________

Customer to complete the following pages:

A five level assessment rating system will be used for the following questions as defined below:

Rating Definition Exceptional Performance meets contractual requirements and exceeds many to the

Government’s/Owner’s benefit. The category 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/Owner’s benefit. The category being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory Performance meets contractual requirements. The category being assessed contains some minor problems for which corrective actions taken by the contractor appear to be or were satisfactory.

Marginal Performance does not meet some contractual requirements. The category being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

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

1. Quality of Project.

a. How would you rate the quality of the project?

Exceptional ( ) Very Good ( ) Satisfactory ( ) Marginal ( ) Unsatisfactory ( ) NOTE: If you provide a rating above or below “Satisfactory” you will need to document your rationale for the use of your rating.

2. Scheduling of Project.

a. How would you rate the scheduling of the project?

Exceptional ( ) Very Good ( ) Satisfactory ( ) Marginal ( ) Unsatisfactory ( ) NOTE: If you provide a rating above or below “Satisfactory” you will need to document your rationale

3. Cost Control of Project Modifications.

a. How would you rate the contractor’s cost control of project modifications?

Satisfactory ( ) Marginal ( ) Unsatisfactory ( ) NOTE: If you provide a rating above or below “Satisfactory” you will need to document your rationale

4. Management of Subcontractors. (Only answer this question if the contractor being evaluated is the general contractor and not a subcontractor)

a. How would you rate the subcontract management demonstrated by the general contractor

Satisfactory ( ) Marginal ( ) Unsatisfactory ( ) NOTE: If you provide a rating above or below “Satisfactory” you will need to document your rationale

5. Would you recommend awarding similar contracts or using the offeror again for future work?

( ) Yes ( ) No

6. Please provide any other comments you may have.