Attach_I_-_Past_Performance_Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Request for Proposal: FA282317R4027

IRCM 4th Lane Facility Modifications Bldg 374 (GWEF); FTFA 16-1126 at Eglin AFB, FL

Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? ☐ Yes ☐ No

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

Note: If offeror holds or has held other contracts with your agency/organization in the last six (6) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone/fax number/e-mail address:

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

E. Other suggested points of contact:

Section 4: Performance Information

In the table below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

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

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance being assessed 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

The Contractor: E V S M U N/

A

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

SUPPORTING INFORMATION:

2. How effective was overall contract management (including ability to effectively lead, manage, control and deliver on-time)?

3. How well did the contractor meet the technical requirements of the specification?

4. How well did the contractor manage quality/effectiveness of subcontracted efforts?

5. How effective was the contractor’s quality control and safety program?

A

6. How well did the contractor meet the schedule and was it kept up-to-date?

7. Contractor provided submittals in a timely manner. Submittals were well researched and clearly identified the proposed item.

8. Paid subcontractors/suppliers in a timely manner.

9. How was the quality of concrete removal and/or foundation work performed on the interior of existing/functioning facility?

10. How was the quality of removing/replacing an existing chilled-water supplied air handling unit and associated controls?

11. How was the quality of the installation of a 1000A, 3-pole breaker (or similar) in an existing switchboard and running a new 1000A electrical service?

12. How was the quality of excavation on the interior of an existing/functioning facility?

A

13. How would you rate the contractor's overall performance on this contract?

14. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.

EXPLANATION:

☐ Yes

☐ No

15. Would you award another contract to this contractor? If not, explain.

EXPLANATION:

☐ Yes

☐ No

Additional remarks:

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address:

Attn: Christopher K. Slater, AFTC/PZIOC (OL-EGLIN)

308 West D Avenue Suite 130

Eglin AFB, FL 32542

FAX to: (850) 882-1680

E-Mail to: christopher.slater.3@us.af.mil; carbon copy to kristina.brannon.1@us.af.mil mailto:christopher.slater.3@us.af.mil mailto:kristina.brannon.1@us.af.mil