Attachment L-1 ITIPSS Past Performance Survey.doc

PAST PERFORMANCE EVALUATION SURVEY

INSTRUCTIONS TO OFFERORS SENDING REFERENCE SURVEY FORMS:

Section A (Part I and Part II) shall be completed by the Offeror (the firm requesting the reference) prior to issuing the surveys. The Offeror shall send the surveys for relevant projects that are in progress or completed in the past five (5) years to the individuals who will provide the reference. For Government contracts, send to the Contracting Officer (CO) or Contracting Officer’s Representative (COR), or Project Manager. For commercial references, send to personnel with duties similar to those for Government contracts. It is the responsibility of the Offeror to follow-up and encourage references to submit the survey. The completed survey shall be submitted via e-mail directly from the person providing the reference.

INSTRUCTIONS TO PERSON PROVIDING REFERENCE:

In order to assess potential vendors under the Federal Aviation Administration (FAA) Information Technology Innovative Procurement Strategic Sourcing (ITIPSS) competition, the FAA contracting office is obtaining past performance information with respect to each Offeror. As a reference for work performed by the firm identified in Section A of this survey, your candid response will assist in the evaluation process. Please complete Section B (Part I and Part II) of the survey as thoroughly as possible and submit to stefanie.m.applegate@faa.gov no later than 2PM EST, on the due date of proposal submission. The subject line in the submission e-mail shall clearly indicate: ITIPSS Past Performance Survey Submission for <Company Name> and the message shall originate from the reference’s government or commercial e-mail system.

In addition to this survey, you may receive a follow-up phone call to confirm or clarify information. This is a major FAA acquisition and your input into this evaluation is greatly appreciated. If you have questions regarding this survey or require assistance, please submit inquiries to: stefanie.m.applegate@faa.gov.

Sincerely, Stefanie Applegate ITIPSS Contracting Officer

Federal Aviation Administration stefanie.m.applegate@faa.gov

SECTION A

To be completed by Offeror (the firm requesting the reference)

PART I: ITIPSS OFFEROR INFORMATION

COMPANY NAME OF ITIPSS OFFEROR:

OFFEROR ADDRESS:

PART II: PAST PERFORMANCE INFORMATION

CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:

CONTRACT/ORDER/SUBCONTRACT NUMBER/OTHER:

CONTRACT NAME OR TITLE OF PROJECT/CONTRACT:

AGENCY:

CUSTOMER POINT OF CONTACT NAME/PHONE NUMBER/EMAIL ADDRESS

NUMBER OF CONCURRENT TASK ORDERS (IF APPLICABLE):

CONTRACT TYPE: (Check all that apply)

FORMCHECKBOX

FP FORMCHECKBOX

CPFF-Completion FORMCHECKBOX CPFF-Term FORMCHECKBOX

CPIF FORMCHECKBOX

CPAF FORMCHECKBOX

IDIQ/Task Order

Requirements FORMCHECKBOX Labor-Hour FORMCHECKBOX

T&M FORMCHECKBOX

CR FORMCHECKBOX

Other (Specify) _______________

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACT /SUBCONTRACT AMOUNT:

· INITIAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

· FINAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

· ANNUAL DOLLAR VALUE: ________________

· CUMULATIVE INVOICED AMOUNT TO DATE _________________

· PERCENTAGE OF PRIME CONTRACT (IF SUBCONTRACTOR) _________%

ROLE ON PROJECT:

PRIME

FORMCHECKBOX

SUBCONTRACTOR (EXPLAIN TYPE AND EXTENT OF SUBCONTRACTING, IF APPLICABLE):

APPLICABLE SUBJECT MATTER SOLUTION AREA:

FORMCHECKBOX

Program Management/Project Planning

FORMCHECKBOX

Compliance and Evaluation

FORMCHECKBOX

Operational Business Intelligence

FORMCHECKBOX

Office Administration

FORMCHECKBOX

Facilities Support

FORMCHECKBOX

Requirements Analysis

FORMCHECKBOX

Enterprise Architecture, Strategy, and Planning

FORMCHECKBOX

Software Development

FORMCHECKBOX

Test & Evaluation

FORMCHECKBOX

Solutions Support and Operations & Maintenance (O&M)

FORMCHECKBOX

Security Management & Support

Asset Management

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE COMPLEXITY OF WORK AND RELEVANCY TO EACH APPLICABLE SUBJECT MATTER SOLUTION AREA IDENTIFIED:

SECTION B

TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)

PART I: REFERENCE INFORMATION

NAME & TITLE:

ORGANIZATION (INCLUDING AGENCY AND/OR COMPANY):

CONTRACT ROLE (e.g. CO, COR or Project Manager):

ADDRESS:

PHONE NUMBER:

FAX NUMBER:

E-MAIL:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

Please identify and correct any information that is not accurate in Section A.

Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most appropriate rating as described below:

Unsatisfactory

1. Technical Performance / Quality of Service

· Met all performance requirements / Exceeded 20 % or more

· Minor problems / Highly effective corrective actions / Improved performance/quality results

· Met all performance requirements / Exceeded 5% or more

· Minor problems / Effective corrective actions

· Met all performance requirements

· Minor problems / Satisfactory corrective actions

· Some performance requirements not met

· Performance reflects serious problem / Ineffective corrective actions

· Most performance requirements are not met

· Recovery not likely

Assessment (Check Box)

2. Cost Control

· Significant reductions while having met all contract requirements

· Use of value engineering or other innovative management techniques

· Quickly resolved cost issues / Effective corrective actions facilitated cost reductions

· Reduction in overall cost/price while having met all contract requirements

· Use of value engineering or other innovative management techniques

· Quickly resolved cost/price issues / Effective corrective actions to facilitate overall cost/price reductions

· Met overall cost/price estimates while having met all contract requirements

· Do not meet cost/price estimates

· Inadequate corrective action plans / No innovative techniques to bring overall expenditures within limits

· Significant cost overruns

· Not likely to recovery cost control

Assessment (Check Box)

3. Schedule (Timeliness)

· Significantly exceeded delivery requirements (All on-time with many early deliveries to the Government’s benefit)

· Quickly resolved delivery issues / Highly effective corrective actions

· On-Time deliveries / Some early deliveries to the Government’s benefit

· Quickly resolved delivery issues / Effective corrective actions

· On-time deliveries

· Minor problems / Did not effect delivery schedule

· Some late deliveries

· No corrective actions

· Many late deliveries

· Negative cost impact / Loss of capability for Government

· Ineffective corrective actions / Not likely to recover

Assessment (Check Box)

4. Business Relations

· Highly professional / Responsive / Proactive

· Significantly exceeded expectations

· High user satisfaction

· Significantly exceeded SB/SDB subcontractor goals

· Minor changes implemented without cost impact / Limited change proposals / Timely definitization of change proposals

· Professional / Responsive

· Exceeded expectations

· User satisfaction

· Exceeded subcontractor goals

· Limited change proposals / Timely definitization of change proposals

· Professional / Reasonably responsive

· Met expectations

· Adequate user satisfaction

· Met subcontractor goals

· Reasonable change proposals / Reasonable definitization cycle

· Less Professionalism and Responsiveness

· Low user satisfaction / No attempts to improve relations

· Unsuccessful in meeting subcontractor goals

· Unnecessary change proposals / Untimely definitization of change proposals

· Delinquent responses / Lack of cooperative spirit

· Unsatisfied user / Unable to improve relations

· Significantly under subcontractor goals

· Excessive unnecessary change proposals to correct poor management

· Significantly untimely definitization of change proposals

Assessment (Check Box)

7. Given the choice, would you do business with this contractor again? If no, please provide reasons.

8. Additional comments you would like to share

Signature

DATE:

PAGE

Attachment L-1– Page 1