PP Questionnaire Attachment 6.doc

Attachment 6

FA3030-09-R-0006

PAST PERFORMANCE QUESTIONNAIRE

FA3030-09-R-0006 Pavement IDIQ

Contractor Being Evaluated:

(If Applicable) Teaming with:

I.

Background. The purpose of this questionnaire is to obtain past performance information relative to contracts that have previously been completed or are currently being performed by the contractor identified above that. This company is a potential source for performing a Pavement IDIQ contract.

II.

Instructions. Please complete the questionnaire based on the following guidance:

A.

Handwritten responses are sufficient.

B.

Indicate, based on the description below, the contractor's performance on the identified program in the assessment area. Assessments should reflect only contractor liable performance. The following is a definition of the scoring levels:

TABLE 5315-2- PAST PERFORMANCE RATINGS

Exceptional/High Confidence

Based on the offeror's performance record, essentially no doubt exists that the offeror will successfully perform the required effort.

Very Good/Significant Confidence

Based on the offeror's performance record, little doubt exists that the offeror will successfully perform the required effort.

Satisfactory/Confidence

Based on the offeror's performance record, some doubt exists that the offeror will successfully perform the required effort.

Marginal/Little Confidence

Based on the offeror's performance record, substantial doubt exists that the offeror will successfully perform the required effort. Changes to the offeror's existing processes may be necessary in order to achieve contract requirements.

Unsatisfactory/No Confidence

Based on the offeror's performance record, extreme doubt exists that the offeror will successfully perform the required effort.

Neutral/Unknown Confidence

No performance record identifiable (see FAR 15.305 (a)(2)(iii) and (iv)).

[Circle the word corresponding to your rating.]

C.

Please provide comments for all questions in which an Unsatisfactory, Satisfactory, or Marginal rating is given and as appropriate for all other answers. Space for your comments is provided in each area. If more space is needed, attach additional sheets to the end of the questionnaire and reference the respective questions.

D.

You are urged to supplement your own knowledge of the offeror's performance with the judgment of others in your organization. In addition to completing the attached questionnaire for the program, we solicit your comments on other similar programs for which your office has contracts with this offeror.

E.

PLEASE FAX, MAIL, OR EMAIL YOUR COMPLETED QUESTIONNAIRE NO LATER THAN THE SOLICITATION CLOSING DATE TO:

ATTN: Mrs. Maria Cachola

17 CONS/LGCA

210 Scherz Blvd

Goodfellow AFB, TX 76908-4705

Commercial FAX: (325) 654-5149 DSN FAX: 477-5149

Commercial Voice: (325) 654-4547 DSN Voice: 477-4547 Email: maria.cachola@goodfellow.af.mil

YOUR ASSISTANCE IN EVALUATING THE CONTRACTOR'S PAST PERFORMANCE IS

APPRECIATED. OUR GOAL IS TO SELECT THE BEST VALUE TO THE GOVERN-MENT. YOUR PAST PERFORMANCE EVALUATION IS A CONSIDERATION IN

DETERMINING THE BEST VALUE.

III. Program Identification. Evaluator, please complete:

A.

Contractor Being Evaluated: _________________________________________

B.

Contract Number: _________________________________________________ C.

Estimated Contract Dollar Amount: ____________________________________

D.

Dates of Contract Performance: _______________________________________

E.

Describe Contract: _________________________________________________

F.

Contract Type: ____________________________________________________

G.

Description of specific work performed by contractor: _______________________

IV. Past Performance Evaluation.

A. Overall performance in planning and managing the construction project?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

B. How well did the contractor's on-site management/superintendent control overall quality?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

C. How well did the contractor manage subcontractors?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

D. How well did the contractor adhere to the contract schedule(s)?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

E. How well did the contractor comply with contract terms and conditions?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

F. Were any cure or delinquency notices issued? If so, explain the situation.

G. IDIQ Contracts: Overall Assessment of Contractor’s initial proposals/estimates under this contract:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

H. IDIQ Contracts: Overall Assessment of Contractor’s modification proposals/estimates under this contract:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

I. IDIQ Contracts: Task/Delivery Order Modifications:

Please provide the approximate percentage for the following modification types:

Government Requested: _________%

Contractor Requested: _________%

Comments: _____________________________________________________________

J. Overall Assessment of Contractor’s performance under this contract:

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Comments: _____________________________________________________________

K. Would you enter into another contract with this contractor?

V.

Respondent Information. The following information will assist in the analysis of the data, and will be kept confidential.

A.

Name of Evaluator: ___________________________________________

B.

Office Symbol/Location: _______________________________________

C.

Phone (Commercial/DSN)______________________________________

D.

Position Title/Grade: __________________________________________

E.

Length of Time on Program/Contract: ____________________________

F.

Date Questionnaire Completed: _________________________________