RAEISPAFB_CCAFSPastPerformance_4_Oct_12.docx

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Attached to
FA2521-12-R-0041 Range Architect Engineer Inspection ServicesRAEIS Federal contract opportunity
Solicitation number
FA2521-12-R-0041
Issued by
Department of the Air Force Space Command

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Revised Past Performance Questionnaire requests submission of ALL (4) pages from respondents.

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RAEIS SOW 6Sep12 Final_1.docx DOCX document
RAEISPAFB_CCAFSPastPerformance_17Sep12.docx DOCX document

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Source Selection Sensitive Information PAFB/CCAFS RAEIS Past Performance Questionnaire

FA2521-12-R-0041

PART 1: PAST PERFORMANCE QUESTIONNAIRE

Contractor Information (To be completed by offeror and submitted with proposal) Provide a separate form for each reference, maximum of ten (10).

A. Offeror Name: ____________________

B. Program/Project Title/Description: ____________________

C. Contract Specifics:

1. Name of Contracting Agency or Client/Customer___________________________________________

2. Contract Number __________________________

3. Contract Type __________________________

4. Period of Performance __________________________

5. Original Contract $ Value _________________

6. Current Contract $ Value __________________

7. If Amounts for 5 and 6 above are different, provide a brief description of the reason D. Brief Description of Effort as __Prime or __Subcontractor (Highlight portions considered most relevant to current acquisition)

E. Completion Date:

1. Original date: ____________________

2. Current Schedule: ____________________

3. Estimate at Completion ____________________

4. How Many Times Changed: ____________________

5. Primary Causes of Change: ____________________

F. Customer/client Points of Contact: (Contact information must be current. Evaluators will not attempt to locate or contact reference(s) with incorrect contact information.)

Project Manager:Name ____________________
Office ____________________
Address ________________________________________
Telephone ____________________

Contracting Officer: Name ____________________

Office ____________________
Address ________________________________________
Telephone ____________________
Administrative:Name ____________________
Office ____________________
Address ________________________________________
Telephone ____________________

PART 2: PAST PERFORMANCE QUESTIONNAIRE

Respondent Information (To be sent to contractor provided references identified under Part 1. Once completed, respondent e-mails or faxes pages 1 - 4 to Contracting Office)

Performance Information: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation. PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

Assigned Ratings

5
Outstanding
4
Excellent
3
Satisfactory
2
Marginal
1
Unsatisfactory

Evaluation Areas:

Please circle a number or indicate “not applicable” (N/A).

1. CUSTOMER SATISFACTION:

A
Customer would have no reservations in awarding another contract to the Contractor.
1
2
3
4
5
N/A

2. QUALITY:

A
Contractor provided effective quality control and/or inspection procedures to meet contract requirements
1
2
3
4
5
N/A
B
Contractor provided well researched and clearly identified submittal that matched contract requirements
1
2
3
4
5
N/A
C
Contractor completed all work with good workmanship and in conformance with the specifications
1
2
3
4
5
N/A
D
Contractor corrected deficiencies in a timely manner and pursuant to their quality control plan
1
2
3
4
5
N/A

3. TIMELINESS:

A
Contractor met established project schedules to complete the project on time
1
2
3
4
5
N/A
B
Contractor provided timely cost proposals
1
2
3
4
5
N/A
C
Contractor submitted the progress schedule and progress reports as required
1
2
3
4
5
N/A
D
Contractor provided on time submittals as required
1
2
3
4
5
N/A
E
Contractor provided payrolls for both their employees and their subcontractors employees as required
1
2
3
4
5
N/A
F
Contractor provided timely resolution of all punch list items
1
2
3
4
5
N/A

4. RESPONSIVENESS

A
Contractor acted promptly to resolve problems, ensuring compliance with contract requirements and safety regulations
1
2
3
4
5
N/A
B
Contractor was reasonable and cooperated to resolve problems, attended meeting as needed, and maintained communication with the government to keep the project on schedule or minimize the delay
1
2
3
4
5
N/A
C
Contractor identified problems as they occurred; suggested approaches to the problems; displayed initiative to solve problems and performed as a Team Member
1
2
3
4
5
N/A
D
Contractor responded to warranty issues within the time frames specified in the contract
1
2
3
4
5
N/A

5. SUBCONTRACTS AND MANAGEMENT:

A
Contractor provided experienced/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements
1
2
3
4
5
N/A
B
Contractor hired quality subcontractors and effectively managed and coordinated their work
1
2
3
4
5
N/A
C
Contractor hire, maintained and replaced as necessary, qualified personnel and subcontractors/suppliers
1
2
3
4
5
N/A
D
Contractor ensured the project manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule
1
2
3
4
5
N/A
E
Contractor ensured site superintendent and quality control representative were consistently present on site when work was performed
1
2
3
4
5
N/A
F
Contractor paid employees/subcontractors/suppliers as required
1
2
3
4
5
N/A

6. CHANGE/COST CONTROL

A
Contractor responsive to contract changes and provided accurate, reasonable and supportable cost proposals
1
2
3
4
5
N/A
B
Contractor demonstrated the ability to control costs and/or modifications within the magnitude specified
1
2
3
4
5
N/A
C
Contractor validated subcontractor cost proposals prior to submission to the Government
1
2
3
4
5
N/A

Narrative Summary

1. What were the contractor’s greatest strengths in the performance of the contract?

2. What were the contractor’s greatest weaknesses in the performance of the contract?

3. Please provide any additional comments concerning the contractor’s performance that you feel would help us in our evaluation.

4. Government Contracts Only. Has/was this contract partially or completely terminated for default or convenience or are there any pending terminations?

______ Yes ________No If yes, please provide explanation____________________________________________________________________

5. Government Contracts Only: Was the contractor ever issued a cure or show cause notice under the referenced contract?

______ Yes ________No If yes, please provide explanation____________________________________________________________________

Evaluated By: _________________________________ ______________________________ (Signature) (Date)

(Typed or Printed Name) (Address)

(Title) (Address Continued)

(Phone Number) (No. of years evaluator worked on contract)

(Project Title, Contract #, Description and Name of Contractor that performed work) Thank you for your prompt response and assistance.

Please return this completed questionnaire (pages 1 –4) to:

Mailing Address: 45CONS/LGCAC

Attn: Patricia Bates and or Robert Moran
14640 Hangar Rd CCAFS/BLDG 1704
MS 2037
Patrick AFB, FL 32925-2206

Or FAX to Non-Secure Fax Number: 321-853-0904

Or E-mail (preferred) patricia.bates@us.af.mil and/or robert.moran@us.af.mil

File details come from the government source that posted it. Updated .