Attachment 3- Past Performance Questionnaire- Pittsburg.pdf

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ATTACHMENT 3

PAST PERFORMANCE QUESTIONNAIRE

NOTE: Offerors are responsible for requesting that at least 3 references complete this past performance questionnaire.

References shall return the completed questionnaire directly to the FAA assigned Contract Specialist, Alicia Prince, Not Later Than the Offer Due Date/Time listed in the SIR. When emailing Questionnaires, the Solicitation Number (697DCK-18-R-00122) must be included in the subject line. References are not to return the completed questionnaires to the requestors.

You have been identified as having been a customer of the following company for services same/similar to Constructing an Office, Breakroom, and Bathroom for the Federal Aviation Administration/ Pittsburg International Airport.

Requesting Company Name:

The Federal Aviation Administration is conducting an evaluation of this company’s previous/current record of performance as part of a source selection process to award a contract for a similar requirement. We cordially request you complete and forward this questionnaire:

Not Later Than: Offer Due Date to alicia.prince@faa.gov

For questions related to this form, please contact Alicia Prince, Contract Specialist, at (404) 305-5085.

1. Company (Customer) Information 2. Point Of Contact (POC):

Name Name / Title

Street Address

City State Zip Code

Phone Number Fax Number

Email Address

3. Products Received:

Briefly Describe Products/Services Received:

Approx. Value of Items Purchased: $ Date You Began Using This Firm:

4. Rate Services Received Please rate Contractor’s compliance to the contract by entering an “X” in the applicable rating block below :

O ut st an di ng

V er y

G oo d A cc ep ta bl e

M ar gi na l

U na cc ep ta bl e N eu tra l

Quality of Service – Quality service provided in a timely manner.

Ability to manage project schedule.

Responsiveness to customer requirements to include communication, customer complaints and commitment to customer satisfaction.

Overall satisfaction with products/services.

5. Please Provide Written Comments To Explain Your Ratings (Use Additional Sheets If Necessary):

mailto:alicia.prince@faa.gov

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6. Rated By:

Signature Printed Name & Title Date

Federal Administration Southern Region – Eastern Acquisition (AAQ-510) 1701 Columbia Ave., College Park, GA 30337