Atch 7. Past Performance Questionnaire.pdf

PDF 75 KB Posted

Attached to
ATFP Construct West Gate ID Check Area Federal contract opportunity
Solicitation number
MXDP143001
Issued by
Department of the Air Force Air Education and Training Command

About this file

This document contains a past performance questionnaire for federal contractors and a solicitation for construction services at Laughlin Air Force Base in Texas. The past performance questionnaire is a three-page form for respondents to evaluate contractors' performance on previous federal contracts. It requests information on contractors, respondents, and ratings of contractors' schedule adherence, management, quality control, submittals, problem-solving, and close-out. The solicitation seeks demolition and construction of facilities at Laughlin AFB's west gate, including a new road, gatehouse, ID check area, and canopy. Interested women-owned small businesses may submit fixed-price proposals by the deadline of March 15, 2023. The North American Industry Classification System code is 236220 and small business size standard is $39.5 million. The Air Force is the contracting agency.

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Text version

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

SECTION A: CONTRACTOR INFORMATION

1. Contractor’s Name and Address:

2. Point of Contact:

3. Phone Number:

4. Contract Number: Contract Type:

5. Project Title:

6. Period of Performance:

SECTION B: RESPONDENT INFORMATION (To Be Completed By Evaluation Respondent)

1. Respondent’s Company Name & Address:

2. Respondent’s Name:

3. Phone Number: Fax Number:

E-Mail:

4. Contract Number: Contract Type:

5. Award Amount: Final Amount:

6. Project Title:

7. Period of Performance:

C. Email COMPLETED QUESTIONNAIRE FORM TO: Mrs. Tacy Boje at tacy.boje.1@us.af.mil or to Mr. Kurt C. Armbruster at kurt.armbruster@us.af.mil

THIS FORM MUST BE RETURNED NO LATER THAN: Proposal due date at 2:30PM Central Standard Time.

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.

1 2 3 4 5 6 Unsatisfactory Marginal None Satisfactory Very Good Exceptional

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.

No record of past performance or the record is inconclusive.

Performance met contract 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

1. Developed realistic progress schedules and completed the project within 1 2 3 4 5 6 N/A the established schedule.

COMMENTS/REMARKS:________________________________________________________________________

2. Provided experienced superintendent, managers, and supervisors, with 1 2 3 4 5 6 N/A the technical and administrative abilities to meet requirements.

COMMENTS/REMARKS:________________________________________________________________________

3. Adequately controlled performance of subcontractors. 1 2 3 4 5 6 N/A COMMENTS/REMARKS:________________________________________________________________________

4. Provided effective quality control which resulted in a quality finished product. 1 2 3 4 5 6 N/A COMMENTS/REMARKS:________________________________________________________________________

5. Provided submittals in a timely manner. Submittals were 1 2 3 4 5 6 N/A well researched and clearly identified the proposed item.

COMMENTS/REMARKS:________________________________________________________________________

6. Identified problems as they occurred. Suggested approaches to resolving problems. 1 2 3 4 5 6 N/A Displayed initiative and cooperation in solving problems. Provided adequate information and pricing for change orders and negotiated them in good faith.

COMMENTS/REMARKS:________________________________________________________________________

7. Provided timely resolution of punch list items and closeout documentation. 1 2 3 4 5 6 N/A COMMENTS/REMARKS:________________________________________________________________________

8. Was the contractor assessed liquidated damages? YES NO (If Yes, briefly explain the circumstances)

9. Based on the contractor’s overall performance, would you rehire this contractor? YES NO

OVERALL PERFORMANCE RATING ___________________________________________________

Signature of Rater: ________________________________________________________ Date: ________________

1 Contractors Name and Address 1:
1 Contractors Name and Address 2:
1 Contractors Name and Address 3:
1 Contractors Name and Address 4:
2 Point of Contact:
3 Phone Number:
4 Contract Number:
Contract Type:
e:
od of Performance:
1:
2:
3:
4:
2 Respondents Name:
3 Phone Number_2:
Fax Number:
EMail:
4 Contract Number_2:
Contract Type_2:
5 Award Amount:
Amount:
e_2:
od of Performance_2:
No record of past performance or the record s nconclusive:
c progress schedules and comp:
COMMENTSREMARKS:
and administrat:
COMMENTSREMARKS_2:
led performance of subcontractors:
COMMENTSREMARKS_3:
4 Provided effective quality control wh:
COMMENTSREMARKS_4:
l researched and clearly identified the proposed item:
COMMENTSREMARKS_5:
ng for change orders and negot:
COMMENTSREMARKS_6:
COMMENTSREMARKS 1:
COMMENTSREMARKS 2:
If Yes br 1:
If Yes br 2:
OVERALL PERFORMANCE RATING:
gnature of Rater:
Date:

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