Attachment 11 - Past Performance Questionnaire.pdf

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

SUBJECT: Request for Past Performance Evaluation

You have been identified as a point of contact for a past and/or present performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for a construction contract at Travis AFB, CA.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, please contact Jonny Ochoa at (707) 424-7736 or jonny.ochoa@us.af.mil

Rory Gardner Contracting Officer

1 Atch Past and Present Performance Questionnaire mailto:jonny.ochoa@us.af.mil

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name:

Address:

Phone Number:

Project Title and Brief Description of Work:

Contract Number Provided by Offeror:

Dollar Amount:

Contract Period or Dates of Performance Provided by Offeror:

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

B. RESPONDENT INFORMATION:

Name of Respondent: Title:

Address: Telephone Number:

Fax Number:

Email Address:

Respondent wet or digital signature: _________________________

C. EMAIL COMPLETED SURVEY FORM TO:

60th Contracting Squadron Attn: Jonny Ochoa jonny.ochoa@us.af.mil mailto:jonny.ochoa@us.af.mil

D. PERFORMANCE INFORMATION: Choose the appropriate number on the scale (1, 2, 3, 4, and 5) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 4 or 5.

1 2 3 4 5

Substantial Confidence

Satisfactory Confidence

Limited Confidence

No Confidence Unknown Confidence

Based on the offeror’s performance record, the government has a high expectation that the offeror will successfully perform the required effort.

Based on the offeror’s performance record, the government has an expectation that the offeror will successfully perform the required effort.

Based on the offeror’s performance record, the government has a low expectation that the offeror will successfully perform the required effort

Based on the offeror’s performance record, the government has no expectation that the offeror will successfully perform the required effort

No performance record is identifiable or the offeror’s performance record is so sparse that no confidence assessment rating can be reasonably assigned.

Place an “X” in the appropriate column using the definitions matrix above.

The contractor: 1 2 3 4 5

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2. Demonstrated the ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Provided effective quality control and/or inspection procedures to meet contract requirements.

5. Identified problems as they occurred.

6. Suggested alternative approaches to problems.

7. How would you rate the contractor's overall performance?

8. Developed realistic progress schedules.

9. Met established project schedules.

10. Provided timely resolution of warranty defects.

11. Provided adequate project supervision.

12. Paid subcontractors/suppliers in a timely manner.

13. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

14. Cooperated with Government personnel after award.

15. Completed projects involving mechanical, electrical and plumbing renovations.

16. Is familiar with Unified Facilities Criteria’s (UFCs) for HVAC, Plumbing and Interior Electrical Systems.

17. Modified fire alarm systems and wet pipe fire sprinkler systems.

The contractor: 1 2 3 4 5

18. Was the contractor ever issued a cure or show cause notice under the referenced contract?

If yes, explain.

EXPLANATION:

□ Yes

□ No

19. Would you award another contract to this contractor? If not, explain.

EXPLANATION:

□ Yes

□ No