Attachment 6 - Past Performance Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

COVER LETTER

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

TO:

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 (SABER IDIQ Firm-fixed price) contract at Altus AFB, OK.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, I can be contacted at ___________________.

Contracting Officer 1 Atch Past and Present Performance Questionnaire

Attachment 6 for FA441920R0001

Past Performance Questionnaire

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

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

Contractor’s Name: ____________________ Telephone Number:

Address: __________________________ Fax Number:

__________________________ Point of Contact:

(The government enters the following information based on list of references provided by the offeror. The offeror will enter this information if the solicitation requires him to submit questionnaires to the references.)

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.

* 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.

(cont)

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title:

Address: _____________________ Telephone Number:

___________________ _____________________________ Fax Number:

_____________________________ Email Address: ___________________

C. FAX COMPLETED SURVEY FORM TO: __________________________________

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

Exceptional Performance meets contractual requirements with many exceeded to the

Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Good Performance meets contractual requirements with some exceeded to the

Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element 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.

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

Neutral Performance was not observed or not applicable to the current effort being reported against.

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER:

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

The Contractor: E G S M U N

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

2. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

3. Met established project schedules.

CONTRACTOR’S NAME: ___________________

CONTRACT NUMBER:_________________

Remarks:___________________________________________________________

4. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

Yes/No

5. Would you award another contract to this contractor? If not, explain in “remarks.”

Yes/No

6. Is the contractor rated in CPARS? Yes/No