Customer Satisfaction Survey.pdf

SIR No. 697DCK-18-R-00527 PAPI Install @ Pago Pago International Airport, AS

Past Performance Survey / Questionnaire

To:

(Name of person completing survey)

Phone: Fax:

Subject: Past Performance Survey of:

(Name of Company)

(Contract Number)

The FAA is pursuing a firm for work associated with the construction/installation of a Distance Measuring Equipment (DME) facility and installation of a fiberglass equipment shelter to serve Runway 28 at the Hazleton Regional Airport located in Hazle Township, PA. As part of the evaluation factors for award, a total of three (3) past performance surveys/questionnaires will be conducted by the Contracting Officer for each offeror. The information will be used to assist the FAA in the selection of a firm to complete the requirement. You have been listed as a past performance reference. We would appreciate your taking the time to complete this survey.

Rate each of the criteria on a scale of 1 to 5, with 5 representing that you were very satisfied (and would hire the firm again) and 1 representing that you were very unsatisfied (and would never hire the firm again). Please rate each of the criteria to the best of your knowledge. If you do not have sufficient knowledge of past performance in a particular area, leave it blank.

Reference Name:

Project Name/ Dollar Value:

Completion Date:

NO CRITERIA UNIT

1 Ability to manage the project cost (minimize change orders) (1-5)

2 Ability to maintain project schedule (complete on-time or early) (1-5)

3 Safety (1-5)

Professionalism and ability to manage (includes design comment responses and prompt payment to suppliers and subcontractors)

(1-5)

Close out process (no punch list upon turnover, warranties, as-builts, operating manuals, tax clearance, etc. submitted promptly)

(1-5)

6 Communication, explanation of risk, and documentation (1-5)

Ability to follow the clients rules, regulations, and requirements (building codes, customer specific policy etc…)

(1-5)

8 Overall customer satisfaction. (1-5)

ADDITIONAL COMMENTS:

Attachment J-5