Attachment J006 - Past Performance Questionnaire.docx

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

INSTRUCTIONS TO OFFERORS SENDING REFERENCE QUESTIONNAIRE FORMS:

Section A (Part I and Part II) shall be completed by the Offeror (the firm requesting the reference) prior to issuing the questionnaires. The Offeror shall send the questionnaires for relevant projects that are in progress or completed in the past five (5) years to the individuals who will provide the reference. The Past Performance Questionnaire must be provided to at least two (2) individuals per reference that represent the Program Office and contracts organization , i.e. Program Manager, Task Order Lead, Contracting Officer’s Representative, Contracting Officer, Contract Specialist, etc. 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 questionnaire by the due date of the proposal in Section L.3.1 of the solicitation. The completed questionnaire 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 EFS 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 questionnaire, your candid response will assist in the evaluation process. Please complete Section B (Part I and Part II) of the questionnaire as thoroughly as possible. The EFS proposals must be submitted to _______no later than ____________. The subject line in the submission e-mail shall clearly indicate: EFS Past Performance Questionnaire Submission for <Company Name> and the message shall originate from the reference’s government or commercial e-mail system.

In addition to this questionnaire, 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 questionnaire or require assistance, please submit inquiries to richard.a.cutts@faa.gov.

Sincerely, Contracting Officer

SECTION A

TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)

PART I: EFS OFFEROR INFORMATION

COMPANY NAME OF EFS OFFEROR:

OFFEROR ADDRESS:

COMPANY NAME OF EFS PERFORMING TEAM MEMBER FOR THIS REFERENCE (IF APPLICABLE):

TEAM MEMBER ADDRESS:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT AND CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:

AGENCY/CUSTOMER:

CONTRACT/ORDER/SUBCONTRACT/OTHER:

CONTRACT TYPE: (Check all that apply)

|_| FP |_| CPFF-Completion |_| CPFF-Term |_| CPIF |_| CPAF |_| IDIQ/Task Order

|_| Requirements |_| Labor-Hour |_| T&M |_| CR |_| Other (Specify) _______________

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACT AMOUNT:

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

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

ROLE ON PROJECT:

|_| PRIME

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

|_| OTHER (EXPLAIN):

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

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, COTR):

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. Please provide clear and concise narrative explanations (both positive and negative) for your answers.

PART III: DEFINITION OF PERFORMANCE LEVELS

PERFORMANCE LEVEL

SATISFACTORY: Performance meets or betters requirements.

UNSATISFACTORY: Performance does not meet requirements.

NOT APPLICABLE: Unable to provide a score. Performance in this area is not applicable to effort assessed.

PROPRIETARY: The answer will lead to release of proprietary data and cannot be provided.

PART IV: PEFORMANCE ELEMENTS

1. Did the Contractor perform the work according to specifications?

The Contractor’s Performance was:

|_| Satisfactory – The Contractor performed the work according to specifications and delivered a work product of adequate or better quality.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Unsatisfactory – The Contractor did not perform the work according to the specifications and/or did not deliver a work product of adequate or better quality.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Not Applicable |_| Proprietary

2. Did the Contractor adhere to contract schedules, including schedules for administrative aspects of performance (i.e. submission of invoices, reports, certifications)?

The Contractor’s Performance was:

|_| Satisfactory – The Contractor adhered to or exceeded contract schedules, including schedules for administrative aspects of performance.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Unsatisfactory – The Contractor did not adhere to contract schedules, including schedules for administrative aspects of performance.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Not Applicable |_| Proprietary

3. Did the Contractor manage costs and deliver the required outputs within budget?

The Contractor’s Performance was:

|_| Satisfactory – The Contractor managed costs and delivered outputs within or under budget.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Unsatisfactory – The Contractor did not manage costs and/or did not deliver outputs within budget.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Not Applicable |_| Proprietary

4. Did the Contractor cooperate and communicate with its customers; and The Contractor’s Performance was:

|_| Satisfactory – The Contractor cooperated and communicated with its customers.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Unsatisfactory – The Contractor did not adequately cooperate and communicate with its customers.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Not Applicable |_| Proprietary

5. Did the Contractor demonstrate an overall commitment to quality and customer satisfaction?

The Contractor’s performance was:

|_| Satisfactory – The demonstrated an overall commitment to quality and customer satisfaction.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Unsatisfactory – The Contractor did not demonstrate an overall commitment to quality and customer satisfaction.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Not Applicable |_| Proprietary

6. Would you do business with this Contractor again?

|_| Yes (Satisfactory) – If given the choice I would do business with this Contractor again.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| No (Unsatisfactory) – If given the choice I would not do business with this Contractor again.

Explanation:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

|_| Not Applicable |_| Proprietary

PART V: EVALUATOR SIGNATURE

Attachment J006 – Page 6