Attachment 4 - Past Performance Survey.doc

DOC document 82 KB Posted Jun 2, 2022

Attached to: Amend 0002 - Elevator Refurbishment & 1 Year Maintenance Agreement at FAA's Air Traffic Facility in Auburn, WA
Solicitation number: 697DCK-22-R-00416
Issued by: Department of Transportation Federal Aviation Administration Northwest Mountain Region

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File	Type	Posted
697DCK-22-R-00416 Amendment 0002.pdf	PDF	Jul 7, 2022
697DCK-22-R-00416 Amend 0001.pdf	PDF	Jun 14, 2022
Attachment 2 - SCA WD No. 2015-5535, Rev. 17 dated 3-15-2022.pdf	PDF	Jun 2, 2022
Attachment 1a - Reference Drawing - For Information Only.pdf	PDF	Jun 2, 2022
RFO 697DCK-22-R-00416.pdf	PDF	Jun 2, 2022
Attachment 1 - Specifications.pdf	PDF	Jun 2, 2022
Attachment 3 - COVID-19 Contractual Requirement.pdf	PDF	Jun 2, 2022

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PAST PERFORMANCE SURVEY INSTRUCTIONS

SOLICITATION NO. 697DCK-22-R-00416

FEDERAL AVIATION ADMINISTRATION ACQUISITION ACTIVITY

Des Moines, WA The Federal Aviation Administration (FAA) is considering a contractor to refurbish an elevator at FAA’s Air Route Traffic Control Center (ARTCC) located in Auburn, WA. As part of the solicitation process, we are collecting past performance information on contractors and their key personnel. This information will be used to assist the FAA in the selection of a contractor to complete the project. You have been listed as a past performance reference.

Please rate each of the criteria according to the following scale:

0 – 25% of the time

Strongly Disagree

PLEASE RETURN COMPLETED RESPONSE TO:

Federal Aviation Administration

ATTN: Cindi Tjelde E-MAIL: cindi.tjelde@faa.gov

26 – 40% of the time

Disagree

41 – 55% of the time

Somewhat Disagree

56 – 70% of the time

Somewhat Agree

71 – 85% of the time

Agree

86 – 100% of the time

Strongly Agree

No Knowledge of This Element

FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED

PAST PERFORMANCE SURVEY

RATER’S Name & Title

RATER’S Organization / agency

RATER’S TEL NO.

RATER’S E-MAIL ADDRESS:

CONTRACTOR’S NAME & ADDRESS

PROJECT TITLE OR DESCRIPTION OF REQUIREMENT:

CONTRACT NUMBER:

CONTRACT VALUE (INCLUDING OPTIONS):

CONTRACT TYPE:

FORMCHECKBOX

FIXED PRICE

FORMCHECKBOX

COST + FEE

FORMCHECKBOX

COMPETITIVE

FORMCHECKBOX

NON-COMPETITIVE

FORMCHECKBOX

SET-ASIDE

FORMCHECKBOX

SEALED BID

FORMCHECKBOX

NEGOTIATED

FORMCHECKBOX

SEALED BID

FORMCHECKBOX

NEGOTIATED

CONTRACT AWARD & COMPLETION DATE:

PAST PERFORMANCE ELEMENT

RATING

Contractor was able to manage project cost.

FORMCHECKBOX

Contractor was able to maintain project schedule (completed on time or early).

FORMCHECKBOX

Contractor adhered to all contract requirements

FORMCHECKBOX

Contractor was efficient in project coordination.

FORMCHECKBOX

Contractor utilized problem solving skills effectively when problems arose during the project.

FORMCHECKBOX

Contractor was able to follow specifications, regulations, and requirements (building codes, customer specific policy, etc.)

FORMCHECKBOX

Contractor made necessary changes or corrective work as necessary in a timely manner?

FORMCHECKBOX

Overall customer satisfaction

FORMCHECKBOX

Comments or additional information:

FOR OFFICIAL USE ONLY - SOURCE SELECTION SENSITIVE WHEN COMPLETED

File details come from the government source that posted it. Updated Jun 2, 2022.