Past Performance Questionniare.pdf

OMB No. 2120-0595 DTFASA-17-R-00813

Attachment 5

Past Performance Survey NAVAIDS, Replace Glide Slope Equipment Shelter at the Sullivan County Airport Swan Lake, New York

PAST PERFORMANCE SURVEY

Solicitation No.: DTFASA-17-R-00813

NAVAIDS, Replace Glide Slope Equipment Shelter at the

Sullivan County Airport Swan Lake, New York

To: ____________________ (Point of Contact) ____________________ (Company) ____________________ (Phone) ____________________ (Fax)

The Federal Aviation Administration is currently evaluating and you were listed as a performance reference. It would be greatly appreciated if you would take 5 or 10 minutes to complete the following information and return to me via email (preferred) by December 4, 2017 . Email (Preferred): michael.hollis@faa.gov or Fax: 404-305-5774

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

Michael Hollis Contracting Officer, AAQ-510ATL Eastern Acquisitions Service Area Southern Region, Tel-404-305-5298

Please identify the project(s) that this company has performed for your organization, description, city, state, and approximate dollar value:

Respond to the following on a scale of 1 to 5, with 3 being Acceptable, and 5 being Outstanding.

1. Did the contractor commit adequate resources in timely fashion to the contract to meet the requirements and to successfully solve problems? 1 2 3 4 5

2. To what extent did the contractor respond positively and promptly to technical direction, contract change orders, etc.? 1 2 3 4 5

3. How reliably did the contractor follow through on commitments? 1 2 3 4 5

NAVAIDS, Replace Glide Slope Equipment Shelter at the

Sullivan County Airport Swan Lake, New York

4. To what extent did the contractor’s management system provide visibility into problems and risks? 1 2 3 4 5

5. How responsive do you think the contractor was to information requests, issues, or problems during the course of the contract? 1 2 3 4 5

6. How effective has the contractor been in identifying user requirements?

1 2 3 4 5

7. To what extent did the contractor have the ability to administer and manage the contract?

1 2 3 4 5

8. To what extent did the contractor issue professional correspondence?

1 2 3 4 5

9. How well did the contractor adhere to the Statement of Work? 1 2 3 4 5

10. What was your level of satisfaction with the contractor’s management and support staff?

1 2 3 4 5

11. What was your level of satisfaction with the contractor’s Supervisor(s)?

1 2 3 4 5

12. To what extent did the contractor submit required reports and documentation in a timely manner? 1 2 3 4 5

13. To what extent were the contractor’s reports and documentation accurate and complete?

1 2 3 4 5

14. To what extent was the contractor’s maintenance and problem tracking/reporting documentation timely, accurate and of appropriate content?

1 2 3 4 5

15. To what extent did the contractor comply with safety requirements?

1 2 3 4 5

16. What was your level of satisfaction with the contractor’s overall quality of service?

1 2 3 4 5

NAVAIDS, Replace Glide Slope Equipment Shelter at the

Sullivan County Airport Swan Lake, New York

17. To what extent was the contractor effective in interfacing with the Government staff?

1 2 3 4 5

18. What was your level of overall customer satisfaction? 1 2 3 4 5

19. To what extent were the contractor’s employees experienced and qualified?

1 2 3 4 5

Respond: Yes or No.

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

21. Was contractor pro-active? Yes: ____ No: ____

22. Did contractor suggest cost-saving changes? Yes: ____ No: ____

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

For Federal contracts:

24. Were there any Labor Department Investigations? Yes: ____ No: ____

24a. If yes, please describe reason and final outcome.

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

25a. If yes, please describe reason and final outcome.

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

26a. If yes, please describe reason and final outcome.

27. Was there a partial or complete termination for default or convenience? Yes: ___ No: ___

NAVAIDS, Replace Glide Slope Equipment Shelter at the

Sullivan County Airport Swan Lake, New York

27a. If yes, please describe reason and final outcome.

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

29. What is/was the duration of the contract? _____________________

30. Were there any performance issues regarding the contractor’s work? If yes, please describe.

Please provide other comments:

Signature: ____________________________

Date: