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AG-4568-S-17-0004
EAZ
IDIQ STAFFING SUPPORT SERVICES
ATTACHMENT 04
| PAST AND PRESENT PERFORMANCE QUESTIONNAIRE |
| When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and 3.104 |
A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:
| Contractor’s Name: | Telephone Number: | Fax Number: |
| Point of Contact: | | Address: __________________________________________ |
Project Title or Brief Description of Work: *
| Contract Number Provided by Offeror: | Dollar Amount: $ |
| Contract Period or Dates of Performance Provided by Offeror: | * |
*Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.
Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.
B. RESPONDENT INFORMATION:
Name of Respondent: Title:
Address:
Telephone Number: Fax Number: Email Address:
C. E-MAIL COMPLETED SURVEY FORMS TO MIKE WALKER AT: mwalker05@fs.fed.us
D. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.
| UNSATISFACTORY |
| MARGINAL |
| SATISFACTORY |
| VERY GOOD |
| EXCEPTIONAL |
| NEUTRAL |
| Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective. |
| Performance did not meet some contractual requirements. |
There were problems, some of a serious nature, for which corrective action was only marginally effective.
Performance met contractual requirements.
There were some minor problems and corrective actions taken by the contractor were satisfactory.
| Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner. |
| Performance met all contract requirements and exceeded many to the government’s benefit. |
Problems, if any, were negligible and were resolved in a timely, highly effective manner.
No record of past performance or the record is inconclusive.i
The Contractor:
| 1. |
| Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements. |
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| Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period. |
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| 3. |
| Delegated authority to project managers and supervisors commensurate with contract requirements. |
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| Home office participated in solving significant local problems. |
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| Followed approved quality control plan. |
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| Provided effective quality control and/or inspection procedures to meet contract requirements. |
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| Corrected deficiencies in timely manner and pursuant to their quality control procedures. |
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| 8. |
| Provided timely resolution of contract discrepancies |
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| Identified problems as they occurred. |
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| Suggested alternative approaches to problems. |
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| Displayed initiative to solve problems. |
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| Developed realistic progress schedules. |
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| Met established project schedules. |
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| Provided timely resolution of warranty defects. |
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| Was responsive to contract changes. |
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| Provided adequate project supervision. |
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| 17. |
| Obtained consent of surety for increases in bonding as work-in- progress increased. |
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| 18. |
| Paid subcontractors/suppliers in a timely manner. |
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| 19. |
| Provided accurate and complete line item cost proposals including all aspects of work required for each task. |
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| 20. |
| Cooperated with Government personnel after award. |
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| 21. |
| How would you rate the contractor's overall performance? |
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| 22. |
| Was the contractor ever issued a cure or show cause notice under the referenced |
contract? If yes, explain outcome in “remarks.”
YES/NO
| 23. |
| Would you award another contract to this contractor? If not, explain in “remarks.” |
| YES/NO |
| 24. |
| Is the contractor rated in CPARS? |
| YES/NO |
CONTRACTOR’S NAME: _ _CONTRACT NUMBER
Remarks: ________________________________________________________________________________
ATTACHMENT 04
Department of Agriculture Forest Service