80KSC025R0009 Section L Appendix 4 - Past Performance Questionnaire.pdf
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- Attached to
- Vehicle Assembly Building (VAB) Power Phase I (Tower C), Project Control Number (PCN): 99300
- Solicitation number
- 80KSC025R0009
About this file
This is a Past Performance Questionnaire template for NASA Kennedy Space Center solicitation 80KSC025R0009, titled "Revitalize Power Systems VAB Tower C." The form is designed for offerors to provide to their past customers for completion and submission to NASA contracting officers LaCorsha Noel and Stephen Crooks via email by the proposal submission deadline.
The questionnaire evaluates contractor performance across multiple areas using a 1-5 rating scale (Unsatisfactory to Exceptional) with N/A option. Technical performance questions assess project management capabilities, labor and equipment resources, engineering shop drawings, schedule adherence, electrical distribution equipment work during outages, construction phasing to minimize facility impact, and contractor management attention. Additional evaluation areas include safety performance (accident reporting and corrective actions), contract administration (prompt payment to employees/subcontractors, Department of Labor compliance), and overall contractor performance including whether cure notices or terminations were issued and if the rater would select the contractor again. The form includes sections for both the offeror and rater to complete with contract details, work descriptions, and contact information, with completed questionnaires remaining confidential within the government.
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NASA/KSC SOLICITATION 80KSC025R0009
SECTION L - APPENDIX 4
PAST PERFORMANCE QUESTIONNAIRE
Revitalize Power Systems VAB Tower C
NASA Kennedy Space Center’s solicitation requires offerors to provide this Past Performance Questionnaire to customers to complete and return to NASA. Past performance raters are requested to submit the completed questionnaires to the contracting officer identified below via e-mail, to arrive not later than the proposal submission date.
Completed questionnaires should be sent to:
Name: LaCorsha Noel and Stephen Crooks Email: Lacorsha.d.noel@nasa.gov / Stephen.e.crooks@nasa.gov Address: NASA John F. Kennedy Space Center Mail Stop: OP-CS Kennedy Space Center, Florida 32899
Raters are requested to complete the questionnaire forms as written since altered or substituted questionnaires may not adequately address the information NASA will be evaluating.
SECTION I. THIS SECTION TO BE COMPLETED BY THE OFFEROR
Name of Contractor Being Evaluated: _______________________________________
Name of Project and Contract/Order Number: _______________________________
Period of Contract Performance (dates): ___________________________________
Place of Contract Performance: __________________________________________
Contract Value at Award: ______________________________________________
Contract Value at Completion or Current Contract Amount: ______________________
Contract Status (Prime or Subcontract?): ___________________________________
Point of Contact: (Rater) Name/Address/Office Phone Number/E-Mail Address:
mailto:Lacorsha.d.noel@nasa.gov mailto:Stephen.e.crooks@nasa.gov
THIS SECTION TO BE COMPLETED BY THE RATER
(THIS QUESTIONNAIRE, WHEN COMPLETED, SHALL NOT BE DISCLOSED TO
ANYONE OUTSIDE THE GOVERNMENT)
Name of Contractor Being Evaluated: _____________________________________________
Name of Project and Contract/Order Number: ______________________________________
Period of Contract Performance (dates): __________________________________________
Place of Contract Performance: _________________________________________________
Contract Value at Award: ______________________________________________________
Contract Value at Completion or Current Contract Amount: ____________________________
Contractor’s Status (Prime or Subcontractor?): _____________________________________
Percentage and Dollar Value of Work Performed by the Contractor:
Dates of Rater’s Involvement in Program/Contract: _________________________________
Brief Description of Work Performed:
Point of Contact: (Rater) Name/Address/Office Phone Number/E-Mail Address:
RATING DEFINITIONS:
On a scale of 1 to 5, with 1 being unsatisfactory and 5 being exceptional, please rate the contractor on the past performance areas included in this questionnaire. A rating of N/A should be used if the question is not applicable or the answer is unknown. Space is provided for any additional comments raters may want to provide. The definitions associated with the 1 to 5 ratings are provided below:
1. UNSATISFACTORY: Performance does (did) not meet most contractual requirements and recovery is not likely (did not occur). The contractual performance contains (contained) serious problem(s) for which the contractor’s corrective actions appear ineffective (were ineffective).
2. MARGINAL: Performance does (did) not meet some contractual requirements. The contractual performance reflects (reflected) serious problem(s) for which the contractor has not yet identified acceptable corrective actions (did not provide acceptable corrective actions).
3. SATISFACTORY: Performance meets (met) contractual requirements. The contractual performance reflects (reflected) some minor problems. Corrective actions being taken by the contractor appear to be effective (Corrective actions taken were effective).
4. VERY GOOD: Performance meets (met) contractual requirements and exceeds (exceeded) some of the Government’s expectations. The contractual performance reflects (reflected) some minor problems and corrective actions being taken by the contractor appear to be effective (Corrective actions taken were effective).
5. EXCEPTIONAL: Performance meets (met) contractual requirements and exceeds (exceeded) many of the Government’s expectations. The contractual performance reflects (reflected) few minor problems and corrective actions taken by the contractor appear to be highly effective (corrective actions taken were effective).
N/A: Not applicable or rater has not observed performance in this area.
CONTRACTOR’S TECHNICAL PERFORMANCE QUESTIONS
1. The effectiveness of the Contractor’s overall project management ability (including but not limited to project managers, quality control managers, trade integrators, safety managers, and superintendents); labor (skilled and unskilled workers); equipment; supplies; tools; and financial resources to successfully perform, provide contract deliverables and complete work in a safe and timely manner.
1 2 3 4 5 NA
Comments:
2. The Contractor’s ability to provide timely and effective contractor management attention at the job site and partner with the owner to resolve technical and schedule issues.
3. The Contractor’s ability to provide quality engineering shop drawings and accurate and complete as-built documentation.
4. The Contractor’s ability to complete work within the required timeframe(s).
5. The Contractor’s ability to coordinate and complete major electrical distribution equipment work during critical outage windows.
6. The Contractor’s ability to safely and successfully implement major electrical distribution equipment modifications in areas remaining operational during the construction process.
7. The Contractor’s ability to provide immediate and effective contractor management attention at the job site and partner with the owner to resolve technical and schedule issues.
Contractor’s ability to provide and adhere to a detailed 2, 3, or 4-week look ahead schedule throughout project for increased team coordination.
8. The Contractor’s ability to provide professional, clean, high quality computer generated shop drawings including but not limited to dimensioned coordination, fabrication, and installation drawings.
9. The contractor’s ability to develop or follow construction phasing plan to allow minimal impact to facilities occupants and utilities.
CONTRACTOR’S SAFETY PERFORMANCE QUESTIONS
10. The Contractor’s ability to report and take corrective actions on safety accidents/incidents in a timely manner.
CONTRACTOR’S CONTRACT ADMINISTRATION PERFORMANCE QUESTIONS
11. The contractor’s ability to provide prompt payment of employees, subcontractors, and suppliers for services and supplies performed/delivered under the contract.
12. The contractor’s compliance with Department of Labor requirements and resolution of reported violations/discrepancies.
13. Has the contractor’s performance required the issuance of any cure notices, show cause letters, or terminations for cause/default? (Please circle Yes or No)
Yes No
CONTRACTOR’S OVERALL CONTRACT PERFORMANCE
14. Would you select this contractor again? (Please circle Yes or No)
Yes No
THIS COMPLETED QUESTIONNAIRE WILL NOT BE DISCLOSED TO ANYONE
OUTSIDE THE GOVERNMENT. THANK YOU FOR TAKING THE TIME TO
COMPLETE THIS QUESTIONNAIRE.
File details come from the government source that posted it. Updated .