Attachment_8_Past_Performance_Questionnaire.doc

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RFP for Base Network and Telephone System
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FA3022-13-R-0007
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Past Performance Questionnaire

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PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

16 May 13

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

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: __________________

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
SATISFACTORY
VERY GOOD
EXCEPTIONAL
No record of past performance or the record is inconclusive.
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.
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.
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.
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.
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.

CONTRACTOR’S NAME: ________________________ CONTRACT NUMBER________________

The contractor:

1.
Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.
1
2
3
4
5
6
2.
Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.
1
2
3
4
5
6
3.
How would you rate the quality of the contractor’s site manager?
1
2
3
4
5
6
4.
How would you rate the quality of the contractor’s employees?
1
2
3
4
5
6
5.
Delegated authority to project managers and supervisors commensurate with contract requirements.
1
2
3
4
5
6
6.
How would you rate the responsiveness of the home/corporate office?
1
2
3
4
5
6
7.
How would you rate the responsiveness of the contractor’s site manager?
1
2
3
4
5
6
8.
Followed approved quality control plan.
1
2
3
4
5
6
9.
Provided effective quality control and/or inspection procedures to meet contract requirements.
1
2
3
4
5
6
10.
How would you rate the quality of the contractor’s contract deliverables/products?
1
2
3
4
5
6
11.
Corrected deficiencies in timely manner and pursuant to their quality control procedures.
1
2
3
4
5
6
12.
Provided timely resolution of contract discrepancies
1
2
3
4
5
6
13.
Identified problems as they occurred.
1
2
3
4
5
6
14.
Suggested alternative approaches to problems.
1
2
3
4
5
6
15.
Home/corporate office participated in solving significant local problems.
1
2
3
4
5
6
16.
Displayed initiative to solve problems.
1
2
3
4
5
6
17.
Met established project schedules.
1
2
3
4
5
6
18.
How well does the contractor control their costs related to the contract?
1
2
3
4
5
6
19.
Was responsive to contract changes.
1
2
3
4
5
6
20.
Provided adequate project supervision.
1
2
3
4
5
6
21.
Paid subcontractors/suppliers in a timely manner.
1
2
3
4
5
6
22.
Provided accurate and complete line item cost proposals including all aspects of work required for each task.
1
2
3
4
5
6
23.
Cooperated with Government personnel after award.
1
2
3
4
5
6
24.
Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”
YES/NO
25.
Would you award another contract to this contractor? If not, explain in “remarks.”
YES/NO
26.
Is the contractor rated in CPARS?
YES/NO
27.
How would you rate the contractor's overall performance?
1
2
3
4
5
6

CONTRACTOR’S NAME: ________________________CONTRACT NUMBER_________________

NOTE: PLEASE PROVIDE REMARKS AS THIS IS VITAL TO ACCURATE RATING OF THE CONTRACTOR.

Remarks: ______________________________________________________________________________ Attachment 8

FA3022-13-R-0007

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