Attachment 0031 - PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM.docx

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Contractor: ____________________ Contract No.:____________________________ Subcontract No. (if applicable):_________________________________

(Agency, Telephone No., E-mail Address & Fax Number)

The following questions pertain to the contractor’s record of past (within the past five years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.

Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.

Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Outstanding (Explanation must be provided in Comments field below)

· Good

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

C. Timeliness of Performance for Services and Product Deliverables.

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

D. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Acceptable

· Marginal (Explanation must be provided in Comments field below)

· Unsatisfactory (Explanation must be provided in Comments field below)

E. General Comments. Provide any other relevant performance information.

Please provide general comments on the below questions:

1. Did the contractor have quality processes in place to ensure that all parts being manufactured were approved for aeronautical application?

2. Were all the contractor's sources/vendors approved to manufacture aviation items to ensure airworthy parts sources?

3. Did the contractor have internal and external parts support in place to ensure they met the contract delivery schedule?

4. Did the contractor's internal and external repair vendors have the capacity/capability to meet the required delivery schedule?

5. Did the contractor have test stand capability/capacity as well as a contingency plan in place to meet the required productions schedule?

F. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

G. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address: