Past Performance Questionnaire.rtf

SOURCE SELECTION INFORMATION IAW FAR 3.104

“FOR OFFICIAL USE ONLY”

FA3020-08-R-0016

ATTACHMENT 5

SOURCE SELECTION INFORMATION IAW FAR 3.104

FOR OFFICIAL USE ONLY

Past Performance QUESTIONNAIRE Survey should be completed and mailed or faxed to:

82d Contracting Squadron/LGCB Attention: Brenda Alvarado 136 K Avenue Suite 1 Sheppard AFB, Texas 76311-2746 Telephone: 940-676-5189 Fax: 940-676-3784

Evaluator complete the following:

1. Organization: __________________________________________

2. Name and Title: ____________________________________________________________

Telephone Number: ___________________ Fax Number: ___________________ Email: _______________________

3. Signature: _____________________________ Date: ________________________

4. Contractor: _______________________________________ Subcontractor: _______________________________________

5. Number of Years Experience (Elevator Technician) ___________________ Licensed: Yes _______ No ________

6. Contract Number: ________________________________

7. Type of Contract: ( ) Negotiated ( ) Sealed Bid ( ) Cost Reimbursement ( ) Fixed Price ( ) Award Fee: ( ) Other:

8. Description and location of work: _____________________________________________________________________________

9. Current Contract Amount: ________________ Status: ( ) Active ( ) Completed

10. Total Contract Amount (To Include All Unexercised Options): _________________

11. Date of award: _______________________

12. Date of completion: _____________________

13. Contracting Officer Name: ____________________________________

Telephone Number: __________________ Fax Number: __________________ Email: __________________________

14. Contracting Officer Representative Name: ___________________________________

Telephone Number: __________________ Fax Number: ___________________ Email: __________________________

Assessment Elements:

Quality of Service Conformance with contract requirements, specifications and standards of good workmanship, e.g., regularly accepted technical, professional, environmental, or safety and health standards.

Schedule Timeliness of contractor regarding the completion of the contract, task orders, milestones, delivery schedules, administrative requirements, e.g., efforts that contribute to or effect the schedule variance

Price Control Not required for firm fixed price or firm fixed price with economic price adjustment.

Assess contractor’s effectiveness in forecasting, managing, and controlling contract price, including reporting and analyzing variances

Business Relations Integration and coordination of all activity needed to execute the contract, specifically the timeliness, completeness, and quality of problem identification, corrective action plans, proposal submittals, and contractor’s history of reasonable and cooperative behavior, customer satisfaction, timely award and management of subcontracts, and history of meeting subcontracting goals.

Management of Key Personnel Contractor’s performance in selecting key personnel, retaining key personnel, supporting key personnel and replacing key personnel when necessary.

Assessment Rating System:

Rating Definition

Exceptional Performance meets contractual requirements and exceeds many, to the Government’s benefit. The contractual performance of the elements or sub-elements was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good Performance meets contractual requirements and exceeds some, to the Government’s benefit. The contractual performance of the elements or sub-elements was accomplished with some minor problems for which corrective actions taken by the contractor were highly effective.

Satisfactory Performance meets contractual requirements. The contractual performance of the elements or sub-elements was accomplished with 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 of the elements or sub-elements reflects serious problems for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were fully implemented.

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the elements or sub-elements reflects serious problems for which the contractor’s corrective actions appear or were ineffective.

Business Relations (Circle or X rating):

12. Did the contractor display effective management?

13. Did the contractor generate businesslike correspondence?

14. To what extent was the contractor responsive to contract requirements?

15. Did the contractor notify the government of problems or potential problems?

16. To what extent was the contractor reasonable and cooperative?

17. To what extent was the contractor flexible in responding to changing needs?

18. To what extent did the contractor take pro-active measures in lieu of reactive actions?

19. To what extent were the contractor’s recommended solutions effective?

20. Did the contractor meet and maintain an effective subcontracting program?

21. To what extent did the contractor cooperate to resolve problems, attend meetings and maintain effective communication to assure satisfactory resolution?

E

E

E

E

E

E

E

VG

VG

VG

VG

VG

VG

VG

S

S

S

S

S

S

S

M

M

M

M

M

M

M

U

U

U

U

U

U

U

Management of Key Personnel (Circle or X rating):

22. Did the contractor select qualified key personnel to meet contract requirements?

23. Did the contractor retain qualified key personnel?

24. Did the contractor support the actions taken by key personnel?

25. Did the contractor replace key personnel due to termination(s), resignation(s), or provide immediate replacement upon vacancies?

26. To what extent were the key personnel technical expertise used or the extent the contractor key personnel gained expertise from the contract performance?

Quality of Service (Circle or X rating):

27. Did the contractor’s quality control plan include effective methods for identifying and resolving problems before they resulted in defective performance?

28. Did the contractor have an effective method for ensuring quality control performance?

29. Did the contractor comply with contract requirements?

30. If required, did the contractor provide accurate reports or schedules in accordance with contract requirements?

31. Did the contractor provide sufficient qualified/experienced personnel for the contract?

32. Did the contractor replace key personnel due to termination(s), resignation(s), or provide immediate replacement upon vacancies?

33. Did the contractor demonstrate technical excellence?

35. Was re-performance the primary method used to correct defective performance?

35. Did the contractor execute a smooth transition of services at the start of the contract?

Additional Comments:

Please fill in this section if you gave the contractor an Exceptional rating.

Please fill in this section if you gave the contractor a Marginal or Unsatisfactory rating. Explain what caused the rating and how the contractor resolved the problem or implemented changes to prevent reoccurrence of the problems.