Attachment 1 - Customer Survey.pdf

SIR No. DTFANM-14-R-00103

ATTACHMENT 1

Past Performance Survey / Questionnaire

Survey ID Lanai Runway 3

GS

To:

(Name of person completing survey)

Phone: Fax:

Subject: Past Performance Survey of:

(Name of Company)

(Name of Individuals)

The Federal Aviation Administration (FAA) is pursuing a firm for the installation/relocation of the existing runway 3 Glide Slope (GS) Facility and the relocation of existing weather equipment at the Lanai Airport in Hawaii. As part of the contracting process, we are collecting past performance information on firms and their key personnel. The information will be used to assist the FAA in the selection of a firm to complete the project. You have been listed as a past performance reference. We would appreciate your taking the time to complete this survey.

Rate each of the criteria on a scale of 1 to 5, with 5 representing that you were very satisfied (and would hire the firm again) and 1 representing that you were very unsatisfied (and would never hire the firm again). Please rate each of the criteria to the best of your knowledge. If you do not have sufficient knowledge of past performance in a particular area, leave it blank.

Reference Name: ______________________________________________

Project Name/ Dollar Value ____________________________________________

Completion Date:_____________________________________________________

NO CRITERIA UNIT

1 Ability to manage the project cost (minimize change orders) (1-5)

2 Ability to maintain project schedule (complete on-time or early) (1-5)

3 Safety (1-5)

Professionalism and ability to manage (includes design comment responses and prompt payment to suppliers and subcontractors)

(1-5)

Close out process (no punch list upon turnover, warranties, as-builts, operating manuals, tax clearance, etc. submitted promptly)

(1-5)

6 Communication, explanation of risk, and documentation (1-5)

Ability to follow the clients rules, regulations, and requirements (building codes, customer specific policy etc…)

(1-5)

8 Overall customer satisfaction. (1-5)

Attach additional sheets for comments if necessary.

Please e-mail the completed survey directly to the undersigned, no later than the submittal due date, at cindi.tjelde@faa.gov or send via fax to 425-227-1055. Thank you for your assistance.

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