Attachment 13-Past_Performance_Questionnaire.pdf

Source Selection Information (When Filled In) – See FAR 2.101 and 3.10

FOR OFFICIAL USE ONLY

Attachment 13 - Past Performance Questionnaire

Space Coast Multiple Award Construction Contract (SCMACC)

RFP # FA252120R0009

Provide the information requested in this form for each contract/project being described. Provide a separate completed form for each contract/project submitted.

SECTION 1: CONTRACT IDENTIFICATION

Project (Check one): #1 #2 #3 #4 #5 #6 A. Company Information

Name:

CAGE Code:

B. Project Specifics:

1. Contracting Agency/Customer:

2. Contract/Task Order Number:

3. Project Title:

4. Period of Performance (PoP): through

5. Original Project Value $

6. Current Project Value $

If the dollar amounts for #5 and #6 (above) are different, provide a brief reason why:

7. Contract Type

FFP Cost Time & Materials Labor-Hour Letter

8. Was it a competitively awarded contract?

Yes No

**A project is defined as a construction project performed under a single task order or stand-alone contract.**

SECTION 1 SHOULD BE COMPLETED BY THE OFFEROR

9. During the contract performance being evaluated, this firm was a:

Prime Contractor Team Member Major Subcontractor

Other (Explain)

10. Type of Work:

Design/Build New Construction Renovation Repair Alteration Other (explain):

11. Disciplines used during this project:

Architectural Civil Electrical Mechanical Structural Other (Specify):

C. Description of Project:

1. Provide a brief description of the project:

2. Provide a description of the work your company self-performed on this project and highlight those activities you consider most relevant to the current acquisition. If the project was a design-build, include a description of the design effort. Include the percentage of the work self-performed.

Percentage of work self-performed %

3. If a subcontractor on the project, please provide information on the prime.

Company Name:

Address:

City State Zip Code

Company POC: Title

Phone Number:

E-mail:

D. Contract Performance Assessment Reporting System (CPARS)

Is/are there CPARS available for this project?

Yes No

E. Project Completion Date

1. Originally Scheduled Completion Date:

2. Current Anticipated Completion Date:

3. Actual Completion Date (if applicable):

4. How many times has the completion date changed?

5. Delay attributed to: Contractor Government Both

6. Reason for Change:

F. Contractor Self-Assessment Past Performance Relevancy Rating

1. Please provide a self-assessment of your relevancy rating for Subfactor 1 "Disciplines."

Subfactor 1 Very Relevant Relevant Somewhat Relevant Not Relevant

To be considered To be considered To be considered To be considered very relevant, the relevant, the somewhat relevant, not relevant, the offeror must show offeror must show the offeror must offeror must show in a single citation, in a single citation, show in a single in a single citation, experience in a experience in a citation, experience experience in a construction construction in a construction construction

Disciplines project over $500K which involves project over $500K which involves project over $500K which involves project:

a. less than $500K civil, electrical, civil, electrical, civil, electrical, and or mechanical, mechanical, and mechanical b. does not involve structural, and architectural disciplines. civil, electrical, and architectural disciplines. mechanical disciplines. disciplines.

Very Relevant

Relevant Somewhat Relevant Not Relevant

Not Applicable

2. Please provide a self-assessment of your relevancy rating for Subfactor 2 "Design-Build."

Subfactor 2 Very Relevant Relevant Somewhat Relevant Not Relevant

To be considered To be considered To be considered To be considered very relevant, the relevant, the somewhat not relevant, the offeror must show offeror must relevant, the offeror does not in a single citation, show in a single offeror must show in a single experience in a citation, show in a single citation, Design-Build 100% design-build construction project, over $500K.

experience in a 65% design-build construction project, over $500K.

citation, experience in a35% design-build construction project, over $500K.

experience in a design-build construction project, over $500K.

E. Contractor/Company Information

1. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

Years Months

City: State Zip Code

Company POC: Title:

Very Relevant

Relevant Somewhat Relevant Not Relevant

Not Applicable

E-mail:

Signature: _____________________________________________________________________ Company Representative Signature*

* Certifies that the above information is true, accurate, and complete.

SECTION 2 - SECTION 4 BELOW TO BE COMPLETED BY THE

CUSTOMER

SECTION 2: EVALUATOR INFORMATION

City: State Zip Code

Evaluator's Name:

Evaluator's

Title: E-mail:

Number of Years Evaluator Worked on Contract:

1. As the evaluator, have you reviewed the contractor provided information in Section 1? Note any discrepancies below.

Yes

No

2. As the evaluator, please verify the disciplines performed by the contractor on this project:

Architectural Civil Electrical Mechanical Structural

SECTION 3:

EVALUATION

Please indicate your satisfaction with the contractor's performance by marking the performance scale indicated in the in the appropriate block. The scale is defined as follows:

RATING DESCRIPTION

EXCEPTIONAL

The contractor's performance meets contractual requirements and exceeds many to the Government's benefit. The contractor's performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD

The contractor's performance meets contractual requirements and exceeds some to the government's benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

SATISFACTORY

The contractor's performance meets contractual requirements. The contractual performance contained 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 reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor's proposed actions appear only marginally effective or were not fully implemented.

UNSATISFACTORY

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problems for which the contractor's corrective actions appear or were ineffective.

NOT

APPLICABLE

Unable to provide a score.

A. Project Management

A1. Demonstrated effectiveness of overall project management (including ability to effectively lead, manage, control, and deliver on-time).

Remarks:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

A2. Communicates effectively with Government team and with on-site supervisors to ensure accurate/timely information flow.

A3. Complied with contractual terms and conditions and required minimal Government direction regarding technical, schedule, and cost requirements.

NOTE:

Please provide remarks for every rating with the exception of "N/A."

A4. Provided experienced managers and supervisors with the technical and administrative skills to: manage subcontractors, hire and retain qualified personnel, resolve disagreements/disputes, and address or replace subcontractors or in-house personnel with poor performance (if necessary).

A5. Accomplished tasks identified for this project by using available resources.

B. Technical Performance

B1. Proposed realistic and achievable technical solutions (design or construction approach).

B2. Responded to emergency, unforeseen conditions, or warranty call(s) in a timely manner (including notifying COR, Contracting Officer, or Project Manager regarding urgent contractual issues).

B3. Provided design and/or construction submittals with minimal corrections needed.

B4. Identified, understood, and mitigated risks to comply with technical requirements.

Source Selection Information (When Filled In) – See FAR 2.101 and 3.104

C. Schedule

C1. Proposed and met realistic schedule milestones.

C2. Managed schedule in response to unexpected technical or contract changes and if applicable, were delays resolved in a timely manner.

C3. Provided pre/post design and/or construction documents (material submittals, manuals, warranties, as-built drawings, etc.) in a timely manner.

D. Safety/Labor Compliance

D1. Maintained a safe environment, adhered to approved safety plan/OSHA requirements, and responded to safety/environmental issues (if applicable) in a timely manner.

D2. Complied with labor laws/standards to include timely submission of payrolls for prime and subcontractors.

E. Customer Satisfaction

E1. Reasonable and cooperative in dealing with the customer (demonstrated professionalism and courtesy, resolved disagreements/disputes, and encouraged open communication).

E2. Responded to customer questions concerning technical/service/ administrative issues and resolved contract problems without extensive customer guidance.

F. Change and Cost Control Management

F1. Submitted realistic and reasonable costs for original contract and if applicable, change order requests with minimal negotiation. Yes No

F2. Planned, prioritized, executed, and managed contract changes or inquiries (i.e., in-scope modifications, change in period of performance, request for information, etc.).

F3. Proposed innovative alternative methods/processes to reduce cost, improve maintainability, etc.

F4. Identified unforeseen conditions and alerted the customer regarding anticipated changes and associated costs before they occurred.

F5. Obtained consent of surety for increases in bonding as work-in-progress increased.

F6. Submitted timely, accurate and complete progress reports and invoices.

G. Quality Control Program

G1. Provided an adequate quality control plan and implemented the plan with success.

G2. Complied with all Federal, State, and local environmental, health and safety regulations.

G3. Performed quality work with minimal rework needed and corrected deficiencies in a timely manner.

G4. Managed the quality and effectiveness of subcontractor performance.

G5. Demonstrated responsiveness in completing punch list items.

H. Overall Performance

H1. Rate the overall performance and the end-user's satisfaction on this project.

SECTION 4: NARRATIVE SUMMARY

1. What was the contractor's strong points in the performance of this project?

2. What was the contractor's shortcomings in the performance of this project?

3. Please state whether the contractor changed key or critical personnel during the course of the project and, if so, were the replacement personnel hired on a timely basis and able to perform the work required for this project.

4. Were cure notices, show cause letters, or notice of concerns issued for poor performance by the Contracting Officer or project manager, or was the contractor ever in breach of contract?

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

6. Civilian/Industry Contracts Only: Has/was this project partially or completely terminated or are there any pending termination actions?

7. Would you have any reservations awarding to this contractor in the future or having them perform one of your critical and demanding projects?

8. Do you know of any other similar projects performed by this contractor? If yes, can you identify contract/task order, the contract/task order number and POC contact information?

9. Please provide any additional comments concerning this contractor's performance.

Signed By

Digital Signature

Date signed

THANK YOU FOR YOUR PROMPT RESPONSE AND ASSISTANCE!

Evaluator Should Submit the Completed PPQ Directly to the Government

Please e-mail this completed questionnaire encrypted to: kimberly.horner@us.af.mil and sandra.seman@us.af.mil

If unable to email PPQ encrypted, send via the Department of Defense (DoD) Secure Access File Exchange (SAFE) at:

https://safe.apps.mil/

As a back-up you can return the questionnaire by mail to the address below:

45 CONS/PKA

Attn: Space Coast MACC 1201 Edward H White II

St, MS7200 Patrick AFB FL 32925-3227 mailto:kimberly.horner@us.af.mil mailto:sandra.seman@us.af.mil