Attachment 5 - Past Performance Questionnaire.pdf

Attachment 5

FA301022R0012

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

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

Name of Contractor/Key Personnel Requesting Evaluation:

Contractor Telephone Number:

Point of Contact:

Name of Contractor/Key Personnel Being Evaluated, if different from above:

Project Title and Brief Description:

Contract # Dollar Amount:

Contract Period of Performance:

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel

Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent: Title:

Telephone Number: Email Address:

C. SEND COMPLETED SURVEY FORM TO: 81st Contracting Squadron, Keesler AFB, MS Attn: TSgt Andrew Cates Email: 81CONS.LGCB.Construction@us.af.mil

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, VG, S, M, U, or NA) that most accurately describes the contractor’s performance or situation. See scale below.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M OR U IN THE REMARKS

SECTION.

mailto:81CONS.LGCB.Construction@us.af.mil

E Exceptional

Performance meets contractual requirements and exceeds many requirements to the Government’s/Customer’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VG

Very Good

Performance meets contractual requirements and exceeds some requirements to the Government’s/Customer’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S Satisfactory

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

M Marginal

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

U Unsatisfactory

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

NA

Not Applicable

Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

CONTRACTOR’S NAME: CONTRACT #:

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

The contractor: E VG S M U NA Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

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

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

Home office participated in solving significant local problems.

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

Corrected deficiencies in timely manner Identified problems as they occurred.

Suggested alternative approaches to problems.

Displayed initiative to solve problems.

Developed realistic progress schedules.

Met established project schedules.

Was responsive to contract changes.

Provided adequate project supervision.

Obtained consent of surety for increases in bonding as work-in-progress increased.

Paid subcontractors/suppliers in a timely manner.

Cooperated with Government personnel after award.

How would you rate the contractor's overall performance?

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

If yes, explain outcome in Remarks section.

Would you award another contract to this contractor? If not, explain in Remarks section.

Is the contractor rated in CPARS?

CONTRACTOR’S NAME: CONTRACT #:

REMARKS: