ATCH_13_10_May_13_PAST_AND_PRESENT_PERFORMANCE_QUESTIONNAIRE.pdf

FA3002-13-R-0026

Attachment 13

ATTACHMENT 13

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IN

ACCORDANCE WITH FAR 2.101 FAR 3.104

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: Address:

Telephone Number:

Fax Number:

Point of Contact:

Project Title or Brief Description of Work:

Contract Number Provided by Offeror: Dollar Amount:

Contract Period or Dates of Performance Provided by Offeror:

*Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

Contractor performed as the: Prime Contractor Sub-Contractor Key Personnel.

B. RESPONDENT INFORMATION:

Name of Respondent: ________________ Title: ________________________________ Address: __________________________ Telephone Number: _____________________ Fax Number: ______________________ Email Address: ________________________

C. **EMAIL/SCAN COMPLETED SURVEY DIRECTLY TO THE CONTRACTING OFFICER**

Ms. Millie Vigil at mildred.vigil@us.af.mil

D. PERFORMANCE INFORMATION: Choose the number on the scale of 0 to 5 that most accurately describes the contractor’s performance or situation.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS.

PERFORMANCE

RATING DEFINITION

(5) Exceptional

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

(4) Very Good

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

(3) Satisfactory

Performance meets contractual requirements. The contractual performance of the element being assessed contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

(2) Marginal

Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s actions appear only marginally effective or were not fully implemented.

(1) Unsatisfactory

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

(0) Not Applicable Unable to provide a score. Performance in this area is not applicable to the effort assessed.

CONTRACTOR’S NAME: ________________________ CONTRACT

NUMBER___________________

Place an “X” in the appropriate column using the definitions matrix above.

Contractor E VG S M U NA Followed approved quality control plan.

Corrected deficiencies in timely manner and pursuant to their quality control procedures.

Provided effective quality control and/or inspection procedures to meet contract requirements.

Identified problems as they occurred.

Provided timely resolution of contract performance discrepancies.

Suggested alternative approaches to problems.

Home office participated in solving significant local problems.

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

Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

Site manager performed duties and provided adequate supervision and leadership of contractor team.

Contractor's use of cross-utilized employees allowed PWS requirements to be met.

Contractor E VG S M U NA Personnel in key positions possessed adequate experience and education.

If contractor utilized one-deep manning in a given position, adequate back up was availabile to ensure PWS accomplishment.

Met the requirements of the contract.

If the contract was is in a geographical area with insufficient local skilled workers, contractor recruited outside labor sufficient to meet PWS requirements.

Met established project schedules.

Contractor provided and adhered to training plan to ensure employees maintained currency throughout life of the contract.

Contractor provided and followed adequate mobilization or phase in plan.

Paid subcontractors/suppliers in a timely manner.

Provided accurate and complete line item cost/price proposals including all aspects of work required for each task.

How would you rate the contractor's overall performance?

Was responsive to contract changes.

Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES/NO

Would you award another contract to this contractor? If not, explain in “remarks.”

YES/NO

Is the contractor rated in CPARS? YES/NO

CONTRACTOR’S NAME: ___________________ CONTRACT NUMBER __________

Remarks:_____________________________________________________________________________