Attachment 08-Performance Survey.pdf

PAST PERFORMANCE SURVEY

Navigational Aids, for Various Locations

The Federal Aviation Administration is currently evaluating

Name of Offeror and you were listed as a performance reference. It would be greatly appreciated if you would take a few minutes to complete the following information and send it within three (3) days of receipt to my attention at: linda.hennequant@faa.gov. Please Reference PPS-DTFASA-17-R-00047 in the subject line.

If you have any questions or comments, feel free to contact me. Thank you in advance for your assistance.

Linda Hennequant, Contracting Officer Federal Aviation Administration Eastern Logistics Service Area College Park, GA 30337 Tel: 404-305-5458 Fax: 404-305-5774

1. Your Name: 2. Your Phone / Email:

3. Your Agency/Company Name:

4. Contract Number: 5. Contract Type: __Firm Fixed Price ____Cost Reimbursement ___ Other (Please Specify)

6. Period of Performance or Date Complete:

7. Type of Work:

Construction__ Service__ Supply__ Other___________________

8. Title of Contract:

9. Description of Contract Service:

10. Dollar Value of Contract: $

NOTE: 1-Unsatisfactory 2-Satisfactory 3-Outstanding Please provide additional comments below for ratings of 1-Unsatisfactory.

1. Did the contractor commit adequate resources to meet the performance schedule? 1 2 3

2. What is your level of satisfaction with the contractor’s ability to manage the contract? 1 2 3

3. How well did the contractor adhere to the Statement of Work/Specification? 1 2 3

4. What is your level of satisfaction with the contractor’s Supervisor(s)? 1 2 3

5. To what extent were the contractor’s employees experienced and qualified? 1 2 3

6. What was your level of satisfaction with the contractor’s overall quality of service? 1 2 3

7. What was your level of overall customer satisfaction? 1 2 3

DTFASA-17-R-00047 Attachment 8 mailto:linda.hennequant@faa.gov

PAST PERFORMANCE SURVEY

Navigational Aids, for Various Locations

Please Respond: Yes or No

8. Were there any cure notices issued? Yes: ____ No: ____

9. Are there any pending terminations? Yes: ____ No: ____

10. Would you recommend this contractor? Yes: ____ No: ____

11. Are you aware of any financial difficulties paying suppliers/subs? Yes: ____ No: ____

a. If yes, please describe.

For Federal contracts:

12. Were there any Labor Department investigations? Yes: ____ No: ____

a. If yes, please describe reason and final outcome.

13. Were there any safety investigations? Yes: ____ No: ____

a. If yes, please describe reason and final outcome.

14. Were there any security investigations? Yes: ____ No: ____

a. If yes, please describe reason and final outcome.

15. Were there any performance issues regarding the contractor’s work? Yes: ____ No: ____

a. If yes, please describe.

Please provide additional comments:

Signature: ____________________________

Date: ____________________________

DTFASA-17-R-00047 Attachment 8