B.08 Attachment 5 - Past Performance Questionnaire.docx

DOCX document 41 KB Posted

Attached to
Replace Liquid Oxygen (LOX) Storage
Solicitation number
W50S8W23R0003
Issued by

About this file

This document contains a past performance questionnaire template for a federal contractor. The questionnaire requests information on a past or present contract including the contractor name, address, point of contact, project title, contract number, dollar amount, and period of performance. It includes a section for a respondent to provide their name, title, and email. The body of the questionnaire contains 24 questions rated on a scale of 1 to 6 assessing the contractor's performance, management, quality control, timeliness, problem-solving, and cooperation on the referenced contract. It inquires whether the contractor received any cure notices and if the respondent would award them another contract. The questionnaire requests information be emailed to two individuals at the Air Force.

The related federal contract opportunity is for the Department of the Army National Guard to replace a liquid oxygen storage system. The solicitation number and opportunity type and issuing agency are provided.

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Text version

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

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

Contractor’s Name:.

Address:

Telephone #:

Point of Contact:

Project Title or Brief Description of Work:

Contract Number and Dollar Amount Provided by Offeror:

Contract Period or Dates of Performance Provided by Offeror:

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

B. RESPONDENT INFORMATION:

Name of Respondent: Title:

C. Email COMPLETED SURVEY FORM TO THE GOVERNMENT AT: christopher.davalos.1@us.af.mil and kristopher.kahle@us.af.mil

D. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

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2
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5
6
UNSATISFACTORY/ NO CONFIDENCE
MARGINAL/ LITTLE CONFIDNENCE
SATISFACTOR Y/SATISFACTO RY

CONFIDENCE

VERY GOOD/ SIGNIFICANT CONFIDENCE
EXCEPTIONAL/ HIGH CONFIDENCE
NEUTRAL/ UNKNOWN CONFIDENCE
Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.
Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective.
Performance met contractual requirements.

There were some minor problems and corrective actions taken by the contractor were satisfactory.

Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner.
Performance met all contract requirements and exceeded many to the government’s benefit.

Problems, if any, were negligible and were resolved in a timely, highly effective manner.

No record of past performance or the record is inconclusive.i

CONTRACTOR’S NAME: CONTRACT NUMBER:

The contractor:

1.
Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.
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6
2.
Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.
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6
3.
Delegated authority to project managers and supervisors commensurate with contract requirements.
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4.
Home office participated in solving significant local problems.
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5.
Followed approved quality control plan.
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Provided effective quality control and/or inspection procedures to meet contract requirements.
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Corrected deficiencies in timely manner and pursuant to their quality control procedures.
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8.
Provided timely resolution of contract discrepancies
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9.
Identified problems as they occurred.
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10.
Suggested alternative approaches to problems.
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11.
Displayed initiative to solve problems.
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12.
Developed realistic progress schedules.
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13.
Met established project schedules.
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14.
Provided timely resolution of warranty defects.
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15.
Was responsive to contract changes.
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16.
Provided adequate project supervision.
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17.
Obtained consent of surety for increases in bonding as work-in- progress increased.
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18.
Paid subcontractors/suppliers in a timely manner.
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19.
Provided accurate and complete line item cost proposals including

all aspects of work required for each task.

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20.
Cooperated with Government personnel after award.
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21.
How would you rate the contractor's overall performance?
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6
22.
Was the contractor ever issued a cure or show cause notice under the referenced

contract? If yes, explain outcome in “remarks.”

YES/NO

23.
Would you award another contract to this contractor? If not, explain in “remarks.”
YES/NO
24.
Is the contractor rated in CPARS?
YES/NO

Additional Remarks: CONTRACTOR’S NAME: CONTRACT NUMBER:

File details come from the government source that posted it. Updated .