Attachment20Past Performance Questionnaire.doc

DOC document 116 KB Posted Aug 10, 2009

Attached to: Simplified Acquisition of Base Engineering Requirements, Multi-Base, Multi-Award Federal contract opportunity
Solicitation number: FA2517-08-R-5002
Issued by: Department of the Air Force Space Command

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Attachment 20- Past Performance Questionnaire

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Past Performance Questionnaire Simplified Acquisition of Base Engineering Services (SABER)

21st Contracting Squadron

Peterson AFB CO

A) Respondent/Agency Information

Firm/Agency Installation:_________________________________________

Name of Respondent:____________________________________________

Title:_________________________________________________________

Phone No:_____________________________________________________

Email:________________________________________________________

Contract/Project/Task Order Information. Include in this section, scope of work, dollar amount, duration of the project and the type(s) of labor used. Also in this section, the respondent should include the start and finish time of the project and contract type.

Name of Firm/Contractor:_________________________________________

Contract/Task Order Number:______________________________________

Contract Type:__________________________________________________

Project Title/Scope of Work:_______________________________________

Value/Dollar Amount of Contract:___________________________________

Performance Period:_______________________________________________

Type of Labor Used:______________________________________________

Scheduled and Actual Completion Date(s)______________________________

B) Past Performance Survey: For the purposes of this survey the offeror will receive an overall assessment of the government’s assurance that the contractor can perform in accordance with the solicitation, using the ratings below. In responding to the survey, please justify and explain all ratings given. Respondent may be contacted to clarify comments or ratings. In order for the government to provide an assessment, please use the following ratings in your assessment of the offeror’s performance on your contract or project:

Outstanding

Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Above Average

Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal

Performance does not meet some contractual requirements. The contractual performance of the element or sub-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.

Unsatisfactory

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

Quality Control

1. Provided effective Quality Workmanship.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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Not Applicable

NARRATIVE:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. The contractor’s quality control system established adequate procedures to find and correct performance discrepancies.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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3. Contractor implemented the Quality Control Plan.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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4. Contractor provided and maintained adequate storage for materials.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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5. Contractor provided adequate submittals in a timely matter.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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6. Contractor provided adequate Quality Control Testing.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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7. Contractor provided adequate As-Built drawings in a timely matter.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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8. Contractor used specified materials.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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9. Contractor identified and corrected deficient work in a timely manner.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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Effectiveness of Management

1. The contractor was cooperative and responsive.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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2. The contractor adequately managed resources and personnel.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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3. The contractor adequately coordinated and worked with subcontractors.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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4. The contractor adequately cleaned the site.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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5. The contractor effectively supervised the jobsite.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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6. The contractor was compliant with laws and regulations.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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7. The contractor conducted themselves professionally.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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8. The contractor effectively reviewed and resolved subcontractors’ issues.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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Timely Performance

1. The contractor initial progress schedule was adequate.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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2. The contractor adhered to approved schedule.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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3. The contractor effectively resolved delays within his control.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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4. The contractor submitted all required documentation accurately and in a timely manner.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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5. The contractor completed all punch list items in a timely manner.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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6. The contractor submitted updated and revised progress schedules in a timely manner.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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7. The contractor was responsive with warranty work.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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Compliance with Labor Standards

1. The contractor corrected all noted deficiencies.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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2. The contractor’s payrolls were properly completed and submitted.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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3. The contractor was compliant with Labor Laws and Regulations with specific attention to the Davis-Bacon Act and EEO requirements.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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Compliance with Safety Standards

1. The contractor had an adequate Safety Plan.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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2. The contractor effectively implemented the Safety Plan.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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3. The contractor corrected all noted deficiencies.

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Outstanding

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Above Average

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Satisfactory

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Marginal

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Unsatisfactory

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Additional Comments:__________________________________________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

C) Again, thank you for your time and effort in assisting us with our requirement.

//signed//

JOHN J. REA

Contracting Officer

File details come from the government source that posted it. Updated Nov 14, 2017.