Past_Performance_Questionnaire.pdf

FA3030-16-R-0002

Attachment 5

PAST PERFORMANCE QUESTIONNAIRE

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. This questionnaire will provide that the company is a potential source for performing a

Grounds Maintenance 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 2- PAST PERFORMANCE EVALUATION RATINGS

Rating Description

Acceptable

Based on the offeror’s performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror’s performance record is unknown. (See note below.)

Unacceptable

Based on the offeror’s performance record, the Government has no reasonable expectation that the offeror will be able to successfully perform the required effort.

Note: In the case of an offeror without a record of relevant past performance or for whom information on past performance is not available or so sparse that no meaningful past performance rating can be reasonably assigned, the offeror may not be evaluated favorably or unfavorably on past performance (see FAR 15.305(a)(2)(iv)). Therefore, the offeror shall be determined to have unknown past performance. In the context of acceptability/unacceptability, “unknown” shall be considered “acceptable.”

[Circle the word corresponding to your rating.]

C. Please provide comments for all questions in which an Unacceptable 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 MAIL, EMAIL, OR FAX YOUR COMPLETED QUESTIONNAIRE, ENSURE IT IS

RECEIVED NO LATER THAN THE SOLICITATION CLOSING DATE AND TIME ON 04 MAY 16

TO:

Daniel L. Newell

17 CONS/LGCA

210 Scherz Blvd

Goodfellow AFB, TX 76908-4705

EMAIL: daniel.newell.4@us.af.mil

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

Commercial Voice: (325) 654-6103 DSN Voice: 477-6103

YOUR ASSISTANCE IN EVALUATING THE CONTRACTOR'S PAST PERFORMANCE IS

APPRECIATED. OUR GOAL IS TO SELECT THE BEST VALUE TO THE GOVERNMENT. 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: __________________________________ mailto:daniel.newell.4@us.af.mil

IV. Past Performance Evaluation.

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

Acceptable Unacceptable Not Applicable

Comments: ____________________________________________________________________________

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

C. How well did the contractor manage subcontractors?

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

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

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

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

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

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

J. 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: _____________________________________________________