Attachment 7 - Past Perform Questionnaire.pdf

Attachment 7

SOURCE SELECTION INFORMATION – See FAR 2.101 and FAR 3.104

PROCUREMENT SENSITIVE – FOR OFFICIAL USE ONLY

PAST PERFORMANCE QUESTIONNAIRE

TITLE: INDEFINITE DELIVERY-INDEFINITE QUANTITY CONSTRUCTION

FEDERAL LAW ENFORCEMENT TRAINING CENTER

CHELTENHAM, MD

(This questionnaire, when filled in, shall be treated as Source Selection Information in accordance with FAR 3.104-3 and shall not be disclosed to anyone outside the Government Source Selection Team)

Contractor__________________________ Contract Number: _______________ Prime? Sub? FFP? YES NO – If no, specify:

Contract Value (Original): $_______________________ ___________________________________ (Current) $_______________________ If Award Fee Contract, What % of the fee has been awarded in each of the last 3 years?

Contract Start & Completion:____________________ ____________________________________

If contractor is behind schedule, list primary causes: ________________________________________

Program Description: (Description of Project Scope of Work)

PLEASE FILL IN THE FOLLOWING RESPONDENT INFORMATION:

NAME: __________________________________ Role relative to contract:

ADDRESS: __________________________________ _________________________________

__________________________________ (ACO, Inspector, Contract Administrator, Project Engineer, Buyer, Quality Assurance Evaluator, Other-explain) FAX No: .__________________________________

PLEASE CHECK THE BOX RELATING TO THE APPROPRIATE RATING FOR EACH OF THE

FOLLOWING AREAS:

NA=Not Applicable, U=Unsatisfactory, M=Marginal, S=Satisfactory, A=Above Average, O=Outstanding For any rating of “Unsatisfactory” or “Marginal”, please provide (1) Rationale for rating, (2) Indication of contractor problem notification, and (3) Contractor’s corrective action, as applicable, in “Additional Remarks”.

PAST PERFORMANCE INFORMATION: N/A U M S A O

1. Quality/acceptability of services delivered

2. Completion of work according to schedule

3. Responsiveness to unscheduled/emergency requirements

4. Performance of all technical requirements

5. Responsiveness to contract changes/ modifications

6. Timeliness of proposal submissions/other reports

7. Sufficiency of material and personnel to accomplish tasks

Attachment 7

SOURCE SELECTION INFORMATION – See FAR 2.101 and FAR 3.104

PROCUREMENT SENSITIVE – FOR OFFICIAL USE ONLY

PAST PERFORMANCE INFORMATION: N/A U M S A O

8. Performance of contract requirements within agreed prices

9. Competent/responsible/effective on-site managers

10. Overall Program Management

11. Attitude (customer relations)

12. Effectiveness in managing subcontractors

13. Adequately prices contract changes/ modifications

14. Contractor’s overall performance

15. Have there been any contract modifications or disputes/claims relative to the contract?

If “yes”, please explain in “Additional Remarks”. Yes: ____ No:____

16. Has action been initiated to cancel or terminate contract for default?

If yes, please explain in “Additional Remarks”. Yes: ___ No:_____

17. Given a choice, would you use this contractor again? Yes: ____ No_____ Do you know anyone else who can tell us about this contractor’s performance? (Please list Name,Phone No. and Fax No.)

Name: ________________________________Phone: _______________Fax: ________________

Name: ________________________________Phone: _______________Fax: ________________

Name: ________________________________Phone: _______________Fax: ________________

Additional Remarks: (Use separate sheets as necessary)

Respondent Signature Date

Please forward questionnaire to the Contracting Officer, Mr. Terrence Gragg at terry.gragg@fletc.dhs.gov mailto:terry.gragg@fletc.dhs.gov