PAST PERFORMANCE QUESTIONAIRE.pdf

SOURCE SELECTION INFORMATION - See FAR 3.104

SOURCE SELECTION SENSITIVE - FOR OFFICIAL USE ONLY

Solicitation Number FA2550-10-R-1000

Attachment #5 Contract Number FA2550-10-_____________________

PAST PERFORMANCE SURVEY

TO:

RETURN TO: 50 CONS/LGCA

JOHN M. MITTELSTEDT, Contract Specialist

210 Falcon Parkway, Ste 2116

Schriever AFB, CO 80912

SUBJECT: Contract__________________

1. Your assistance is respectfully requested in providing information on the attached performance questionaire. The importance of your opinion cannot be overstated. This survey measures the past performance of

____________________, a prospective offeror on our request for proposal (RFP)

FA2550-10-R-1000. The subsequent contract will require the successful contractor to provide refuse and recycling services for Schriever AFB, CO.

2. For the purpose of satisfying the requirement to accurately measure past performance, contracts, leasing, or subcontracts in which performance has occurred by the aforementioned offeror in the past three (3) years are being surveyed.

3. INSTRUCTIONS FOR COMPLETION: Fill it in by hand, or type and please return the results to either adress listed above, e-mail, or send by facsimile to commercial phone number (719) 567-3438, DSN 560-3438. Point of

Contact is John Mittelstedt (719) 567-3453 or Robert Heinrich (719) 567-3442. Your participation is greatly appreciated. Explanation of codes:

Code Rating Performance Level Definition

E Exceptional/High Indicates the company’s performance or situation within the area of

Evaluation clearly EXCEEDS ALL contractual requirements/expectations

(as applicable).

VG Very Good/ Significant Indicates the company’s performance or situation within the area of evaluation EXCEEDS SOME contractual requirements/expectations (as applicable), while MEETING ALL OTHER contractual requirements/expectations (as applicable).

S Satisfactory Indicates the company’s performance or situation within the area of evaluation MEETS ALL contractual requirements/expectations (as applicable).

N Neutral/Unknown Indicates the company was not required to accomplish this contractual requirement or that no performance record identifiable (reference FAR

15.305(a)(2)(iii) and (iv).

M Marginal/Little Indicates the company’s performance or situation within the area of evaluation MEETS ALL CRITICAL contractual requirements/expectations (as applicable) and DOES NOT MEET OTHER

NON CRITICAL contractual requirements/expectations (as applicable).

U/S Unsatisfactory Indicates the company’s performance or situation within the area of

Evaluation DOES NOT MEET ONE OR MORE CRITICAL contractual requirements/expectations (as applicable).

Circle the appropriate letter for each item on the questionaire and provide narrative justification.

PLEASE RETURN NO LATER THAN THE PROPOSED CLOSING DATE

PAST PERFORMANCE QUESTIONAIRE

Integrated Solid Waste Management

BACKGROUND INFORMATION:

Reference Name:

a. Address:

b. Phone:

c. Point of Contact:

d. Contract Title/Number:

e. Contractor Name:________________________________________________________

f. Contractor Adress/Phone:__________________________________________________

g. Period of Performance/Dates:_______________________________________________

h. Type of service:_________________________________________________________

i. Contract Value Start: End:

j. Type of contract (RFP, IDIQ)

k. Modifications/Change Orders:

l. Reason for any Change:

Past Performance is a measure of the degree to which an offeror, as a organization, has (1) has satisfied its customers, and (2) complied with state, federal laws and regulations. The

Government will determine this with the following questions.

1. How would you rate the contractor’s overall performance in terms of quality, timeliness, professionalism, and courtesy?

Exceptional Acceptable Marginal Unacceptable

Comments:

2. How would you rate the overall quality and reliabilty of the services performed by the contractor?

3. How would you rate the contractor ability to recruit and maintain qualified personnel?

4. What was the contractors overall compliance with contract terms and conditions?

5. Delivery schedules. Did the contractor meet performance schedules?

6. How effective was the contractor in building and maintaining positive working relationships with your company or the Government?

7. How did the contractor act/react with the customer i.e. CO, CA, QAE, etc?

8. How would you rate the Contract Manager/Project Manager’s handling of short notice or special requests in a professional cooperative and timely manner with adequate resources?

9. Has the contractor ever been given a cure notice? A suspension or show cause notice?

Yes ____ (please explain) No ____

10. Does the contractor have record/history of compliance with Enviromental, Safety, and

Quality Control while complying with all local, state, Federal, and Government regulations?

11. Based on this contractor’s overall performance would you award this contractor another contract?

Yes ____ (please explain) No ____

12. Circle the letter that best describes your customer satisfaction:

a) Unsatifactory: Customer refused to accept end product.

b) Marginal: customer sissatisfaction with end product/service evidenced by written or verbal conversations.

c) Satisfactory: customer expressed no displeasure with performance of the contractor.

d) Very Good: customer expressed verbal or written appreciation of the Contractor’s performance.

e) Exceptional: customer expressed admiration of the contractor’s performance and stated he/she would be happy if the Contractor was obtained for future projects.

Comments/Remarks:

13. Circle the letter that best describes your experiences with the Contractor based on the statements below:

a) They were an unsatisfactory Contractor. We would not want to contract with this firm again under any circumstances.

b) They were a marginal Contractor. Numerous problems developed that were a result of their lack of cooperation and failure to perform work as required.

c) They were a satisfactory Contractor who met the minimum requirements of the contract.

Performance deficiencies improved when identified by the Government. Although rework/warranty issues were performed, an aggressive inspection program was required to ensure compliance.

d) They were a Very Good Contractor whom we would not hesitate to enter into another contract. Problems encountered were minor and solutions were found with little difficulty.

e) They are an Excveptional Contracting firm in every aspect. Problems were solved in a spirit of teamwork. Quality work, timely actions, and complete documentations were routinely achieved. We would pay premium prices to contract with them again.

Comments/Remarks: