Attachment 5 -Past Perf Questionnaire_20250603.pdf

ATTACHMENT 5: PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

This Past Performance Questionnaire is provided as a Federal Aviation Administration (FAA) acquisition under the FAA SAVES requirement. The Offeror who provided this questionnaire is doing so under the SAVES HWSW Screening Information Request (SIR) 697DCK-25-R-00302.

The FAA would greatly appreciate you taking the time to complete this form and returning it to the Government Point of Contacts , Dawn Bloome and Kristin Frantz via email at Dawn.A.Bloome@faa.gov and Kristin.T.Frantz@faa.gov.

Please complete this questionnaire based on the following guidelines:

a) Handwritten responses are acceptable.

b) Indicate, based on the ratings identified on page 2, the Contractor’s performance on the contract identified in

Part Two. Assessments should reflect only performance for which the Contractor is/was responsible.

c) Please provide narrative explanations for any ‘Marginal’, ‘Unsatisfactory’ or ‘No’ ratings. Space for your narrative remarks is provided on the last page of the survey. If more space is needed, please add a continuation page.

d) You are requested to provide your own knowledge of the contractor’s performance for the contract identified in Part Two. In addition to completing the attached survey for the identified contract, the FAA solicits your comments on other similar programs/contracts for which your organization has contacts with this Offeror.

PART TWO: QUESTIONNAIRE

PAST PERFORMANCE QUESTIONNAIRE

SIR # 697DCK-25-R-00302

Federal Aviation Administration SAVES HWSW

Submit completed past performance questionnaire by ___________ to the Government POCs:

Dawn Bloome and Kristin Frantz at Dawn.A.Bloome@faa.gov and Kristin.T.Frantz@faa.gov.

(1) Name of Contractor being evaluated:

(2) Contract Number and Order Number (if applicable):

(3) Role Contractor played in Contract identified in #2 above: Prime Subcontractor Other

(4) Proposed Role in SAVES HWSW Contract: Prime Subcontractor Other (4a) Proposed Prime Contractor for SAVES HWSW Contract:

(5) Contract Type:

(6) Contract Awarded Value (including all Orders):

(7) Contract Annual Awarded Value (including all delivery orders, reference Section M.3.2):

(8) Period of Performance (including all Options):

(9) Name of Respondent:

(10) Position/Title:

(11) Agency:

(12) Phone No. and Email:

(13) Length of involvement in program/contract:

(14) Date questionnaire was completed:

RATING SCALE: Please use the following ratings to answer the questions on page 2.

Rating Definition

Excellent Performance meets contractual requirements and exceeds many requirements to the benefit of the Government. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective.

Good Performance meets contractual requirements and exceeds some requirements to the benefit of the Government. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor were effective.

Satisfactory Performance meets contractual requirements. The contractual performance of the element being assessed contains some minor problems for which corrective actions taken by the contractor appear to be or were satisfactory.

Marginal Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the Contractor has not yet identified corrective actions or the Contractor’s corrective actions appear only marginally effective or were not fully implemented.

Unsatisfactory Performance does not meet most contractual requirements and corrections are not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor’s corrective actions appear to be or were ineffective.

N/A (Not applicable) should be used if the ratings are not going to be applied to a particular area for evaluation

NOTE: For statements indicating less than “Satisfactory”, please provide a brief explanation in the comments section of the survey.

CONTRACTOR PAST PERFORMANCE QUESTIONNAIRE

E xc ell en t

Go od

Sa tis fac tor y

M ar gin al

Un sa tis fac tor y

N/ A

A.) QUALITY OF SERVICE:

(1) How successful was the Contractor in providing a service that conformed to contract requirements, specifications, and standards of good workmanship?

(2) How successful was the Contractor in submitting accurate reports?

(3) How successful was the Contractor in proposing and utilizing skilled personnel that were appropriate to the effort?

(4) How successful was the Contractor in having minimal personnel turnover that did not adversely affect Contract performance?

(5) How successful was the Contractor in committing adequate customer support resources in a timely manner to assist with and/or resolve problems that arose during performance?

(6) How would you rate the Contractor’s ability to quickly respond to frequently changing requirements?

(7) How responsive to technical and/or contractual direction was the Contractor?

(8) How effective was the Contractor’s performance transitioning in the work being performed under the Contract?

B.) TIMELINESS OF PERFORMANCE:

(1) How successful was the Contractor in performing tasks/services/deliveries under this effort in a timely manner and according to the agreed upon order/schedule?

(2) How successful was the Contractor in submitting deliverables in accordance with contract requirements?

(3) How successful was the Contractor in completing end products and services (products conformed to requirements)?

C.) CUSTOMER SATISFACTION: (CIRCLE ONE)

(1) The services provided by the Contractor adequately met the needs of the program. YES NO

(2) The Contractor performed with minimal or no direction from the COR or the TPOC. YES NO

(3) I am satisfied with the performance of the Contractor under this effort. YES NO

(4) I would recommend use of this Contractor again. YES NO

D.) CUSTOMER SERVICE RELATIONS AND EFFECTIVE MANAGEMENT OF

ASSETS:

(1) How well did the Contractor demonstrate effective customer service for equipment installation and set up?

(2) How well did the Contractor maintain an open line of communication so that the Technical Point of Contact (TPOC) were apprised of status and/or issues as it related to: equipment delivery, instruction materials, warranty services, damaged items?

(3) How well did the Contractor demonstrate cooperative and responsive behavior to customers issues and complaints?

(4) How well did the Contractor promptly notify the COR, TPOC, and/or Contracting Officer in a timely manner regarding urgent issues?

(5) How well did the Contractor cooperate in providing resolution of complexities and difficulties characteristic to integrating, maintaining, and securing mission critical assets?

(6) How successful was the Contractor in effectively managing its subcontractors?

E.) ABILITY TO MANAGE COST:

(1) How successful was the Contractor in performing the effort within the estimated cost/price?

(2) How successful was the Contractor in submitting accurate invoices on a timely basis?

(3) How successful was the Contractor in demonstrating cost efficiencies in performing the required effort?

(4) The actual costs/rates realized closely reflected the negotiated costs/rates. (circle one) YES NO

COMMENTS: