L-2 FA3022-10-F-0002 Past Performance Questionnaire.pdf

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and 3.104

FA3022-10-R-0002 Attachment L-2

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: _______________________________________

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. FAX COMPLETED SURVEY FORM TO THE GOVERNMENT AT: ATTN: Kevin Crown or Mary Moseley, 662-434-

3049 or scan and email to kevin.crown@columbus.af.mil or mary.moseley@columbus.af.mil .

D. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

1 2 3 4 5 6

NEUTRAL UNSATISFACTORY MARGINAL SATISFACTOR

Y

VERY GOOD EXCEPTIONAL

No record of past performance or the record is inconclusive.

Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.

Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective.

Performance met contractual requirements.

There were some minor problems and corrective actions taken by the contractor were satisfactory.

Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner.

Performance met all contract requirements and exceeded many to the government’s benefit.

Problems, if any, were negligible and were resolved in a timely, highly effective manner.

CONTRACTOR’S NAME: _________________________________ CONTRACT NUMBER___________________________

The contractor:

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

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

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

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

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

8. Provided timely resolution of contract discrepancies

9. Identified problems as they occurred.

10. Suggested alternative approaches to problems.

11. Displayed initiative to solve problems.

12. Developed realistic progress schedules.

13. Met established project schedules.

14. Provided timely resolution of warranty defects.

15. Was responsive to contract changes.

16. Provided adequate project supervision.

17. Obtained consent of surety for increases in bonding as work-in-progress increased.

18. Paid subcontractors/suppliers in a timely manner.

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

20. Cooperated with Government personnel after award. 1 2 3 4 5 6

21. How would you rate the contractor's overall performance? 1 2 3 4 5 6

22.

Was the contractor ever issued a cure or show cause notice under the referenced contract?

If yes, explain outcome in “remarks.”

YES/NO

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

YES/NO

24. Is the contractor rated in CPARS? YES/NO

CONTRACTOR’S NAME: ___________________________________ CONTRACT NUMBER_______________________

NOTE: PLEASE PROVIDE REMARKS, as this is vital to accurate to accurate rating of the contractor.

Remarks: