Attachment_4_-_Past_Performance_Questionnaire.pdf

Source Selection Information - See FAR 2.101 and 3.104

PERFORMANCE QUESTIONNAIRE

RETURN COMPLETED QUESTIONNAIRE FORM NO LATER THAN 3:00 PM EST 28 SEP 16 TO:

11 CONS/LGCBA

Attn: Carolina I. Brost 1349 Lutman Drive

Joint Base Andrews, MD 20762

Phone Number: 240-612-5632

Fax number: 240-612-2176

E-mail: carolina.i.brost.civ@mail.mil

A. OFFEROR’S INFORMATION:

Company/Organization Name:

Address:

Point of Contact (POC):

B. RESPONDENT INFORMATION:

Company/Organization Name:

Address:

Telephone Number:

Point of Contact (POC):

Title of POC:

Offeror Performed as (Prime

Contractor or Sub-Contractor):

C. CONTRACT INFORMATION:

Contract Title:

Contract Number:

Contracting Officer:

Phone Number:

Status (i.e. On-going, complete):

Contract Amount (total amount of base plus any options):

Performance Period (include base plus any options):

Place of Performance:

D. BRIEF DESCRIPTION OF CONTRACT REQUIREMENTS:

E. Please provide a rating to sections a-c below using the evaluation criteria below:

1 2 3 4 5

Unsatisfactory Marginal Satisfactory Very Good Exceptional

Performance does/did not meet most contractual requirements.

Performance does/did not meet some contractual requirements.

Performance meets/met contractural requirements.

Performance meets/met contractual requirements and exceeds/exceeded some to the

Government’s benefit.

Performance meets/met contractual requirements and exceeds/exceeded many requirements to the Government’s benefit.

a. PERFORMANCE and SUPPORTABILITY:

(1) The contractor provided quality service that adhered to contract requirements, specifications, and standards of professional conduct.

1 2 3 4 5 NA

(2) The Ccontractor provided quality personnel that met or exceeded the required certifications of National Fire Protection Agency Standard 96.

1 2 3 4 5 NA

(3) The The contractor’s services were in accordance with NFPA

Standard 96.

1 2 3 4 5 NA

(4) The contractor had the ability to respond effectively to contract performance issues.

1 2 3 4 5 NA

(5) The contractor provided required documention/reports in a timely manner.

1 2 3 4 5 NA

b. MANAGEMENT:

(1) The contractor demonstrated an overall effective and quality management effort. 1 2 3 4 5 NA

(2) The contractor maintained an open line of communication so that the

Contracting Officer’s Representative (COR) was apprised of schedule and technical issues.

1 2 3 4 5 NA

(3) The contractor provided proactive and effective management of its subcontractors. (If applicable)

1 2 3 4 5 NA

(4) The contractor maintained an effective ongoing Quality Control Plan to provide for monitoring, analyzing and improving quality contract performance.

1 2 3 4 5 NA

c. TIMELINESS/SCHEDULE:

(1) The contractor performed services in accordance with cleaning schedule.

1 2 3 4 5 NA

(2) The contractor arrived for scheduled services in a timely manner. 1 2 3 4 5 NA

F. OTHER:

(1) Would you award this contractor another contract? ( ) Yes, ( ) No. If you answered “No”, please provide an explanation.

(2) Has the contractor ever been given a cure notice, show cause notice, suspension of progress payments, etc.?

( ) Yes, ( ) No. If you answered “Yes”, please provide an explanation.

(3) Based upon the information you provided and using the definitions provided in the evaluation criteria above, the overall performance rating you would give this contractor is:

Exceptional ___ Satisfactory ____ Marginal ___ Unsatisfactory ____ Unknown ___

(4) COMMENTS: Please provide comments to all Unsatisfactory, Marginal or Exceptional ratings given above:

(3) The contractor demonstrated the ability to plan for and provide replacement candidates during the life of the contract to include pre-planned absences, unplanned illnesses, or an extended leave of absence.

1 2 3 4 5 N/A

(4) The contractor was able to resolve customer complaints quickly and effectively.

1 2 3 4 5 NA