ATCH_2_A-E_Past_Performance_Questionnaire.pdf

Attachment 2

PAST PERFORMANCE QUESTIONNAIRE

The contractor listed below is being considered in a competitive acquisition by the 47th Contracting Flight. Please complete this Questionnaire and submit on or before 22 Jan 2013. Send completed questionnaires to: 47 CONF/LGCB, Attn: Justin Cole, 171 Alabama Ave, Laughlin AFB, TX 78843-5102 or email to justin.cole.1@us.af.mil, with a copy to

Contract Specialist, Kenneth Montgomery (kenneth.montgomery.5@us.af.mil). Your comments are considered FOR

OFFICIAL USE ONLY. Therefore, you are advised that the Procurement Integrity Act prohibits the release of the names of individuals providing the reference information about an offeror’s past performance. In order to maintain the integrity of the acquisition process, it is requested that you do not divulge the name of the contractor or discuss your comments on this questionnaire with any other individuals.

Past Project Information (completed by firm)

1. Offeror

2. Address

3. Phone Number

4. Firm being evaluated (offeror or team subcontractor)

5. Contract Number/Project Title being evaluated

Evaluator (completed by firm)

1. Name of Evaluator

2. Email Address

3. Firm/Agency Name and Address

4. Phone Number

5. Position held or function in relation to project

Rating: Please evaluate the contractor’s performance using the following ratings only (completed by evaluator):

“E” Excellent Performance meets contractual requirements and exceeds the Government’s expectations. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective

“S” Satisfactory Performance meets contractual requirements. The contractual performance of the element contains some minor problems for which corrective action taken by the contractor appear or were satisfactory.

“M” Marginal Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

“P” Poor Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

“N” Neutral No relevant past performance record is identifiable upon which to base a meaningful performance risk prediction. A search was unable to identify any relevant past performance information for the contractor or their key personnel. (This is neither a negative nor positive assessment)

“N/A” Not Applicable Not applicable to this project

Do not rate on a plus (+) or minus (-) scale. Please use only the ratings provided above, without variation

PAST PERFORMANCE QUESTIONNAIRE (continuation sheet)

Please rate and provide any supporting information for the following:

1. Cost Control and Cost-Effective Performance: Rating:

a. Ability to track and control expenditures, invoiced costs and projected costs.

b. Reasonableness, timeliness and accuracy of cost/price proposals and supporting data

c. Initiative to minimize project costs.

Comments:

2. Quality Control with Contract Specifications and Schedules: Rating:

a. Quality of work (technical, professional and environmental).

b. Quality of data submittals and reports.

c. Ability to manage and track government property (if applicable).

3. Schedule Control: Rating:

a. Ability to manage schedule timeliness of products and services.

b. Timeliness of data submittals and reports.

4. Compliance with Law and Regulations: Rating:

a. Adequacy of responses to regulator comments and concerns.

b. Effectiveness in interfacing with regulators, concerned community groups and stakeholders.

c . Compliance with safety standards and/or number of safety related incidents.

5. Performance

a. Would you award another contract to this contractor?

If not, please indicate why:

Yes: ___________ No:____________

b. Has the Contractor been provided an opportunity to discuss any negative performance ratings? If so, what were the results?

Yes: ___________ No:____________

PAST PERFORMANCE QUESTIONNAIRE (continuation sheet)

Please provide any additional applicable comments regarding the contractor’s performance:

OVERALL RATING:_________________