FA3047-10-R-0012 Atch 4

SECTION J – ATTACHMENT 4

Past Performance Questionnaire 20 April 2010

Solicitation: FA3047-10-R-0012

Title: Roofing IDIQ

Project Number: MPLS 09-1011D

Volume 2, Past Performance Information and/or Questionnaires are due no later than:

Date: 7 Jul 10 Time: 11:00 A.M. (CST)

Suggested Request Letter

DDMMYY

FROM: Your Firm Name

1. You have been identified as a Point of Contact (POC) for a past and/or present performance evaluation of YOUR FIRM. YOUR FIRM is currently being considered for an Roofing Indefinite Delivery, Indefinite Quantity (IDIQ), Firm-Fixed Price (FFP), Single Award, SBA 8(a) Set Aside Acquisition for 802D Contracting Squadron (802 CONS) at Lackland AFB TX.

2. Your prompt attention to this Past Performance Questionnaire will be greatly appreciated. Please be sure to email (preferred method) or fax (210) 671-3360 the completed worksheet directly to the Contracting Specialist:

3. If you have any questions or concerns regarding this request, please contact Mr. Jack Murray, Contracting Officer at (210) 671-1728 or by email jackie.murray@us.af.mil.

Attached

1. Past Performance Questionnaire, dated 20 Apr 10

SOURCE SELECTION SENSITIVE WHEN PAST PERFORMANCE QUESTIONNAIRE IS COMPLETED

NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS

Past Performance Questionnaire

SECTION A. Contractor Information (to be completed by the contractor requesting information)

2. Contractor’s POC: Name & Title

3. Phone: (***) ***-**** Fax: (***) ***-**** Email: **********@********

4. Contract or Reference Number: ******-**-*-****

5. Project Title: ***********************************************

6. Description of Work: ***********************************************

7. Contract Type (examples): FFP – IDIQ – Cost-Reimbursement – Single – Multiple Award

8. Award Date: DDMMMYY Scheduled Completion Date: DDMMMYY

Current / Completion Date: DDMMMYY

9. Project Award Amount: $*,***,***.** Current / Final Amount: $*,***,***.**

10. Contractor being evaluated performed as the (choose): Prime Contractor Sub Contractor

11. Authorization is hereby granted to provide the information requested in Sections B and C of this Past Performance Questionnaire:

SOURCE SELECTION SENSITIVE WHEN PAST PERFORMANCE QUESTIONNAIRE IS COMPLETED

NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS

SECTION B. To be completed by a representative (respondent) responsible for current / past performance information in Section A of this document.

The following definitions are guidance in providing ratings:

Rate how the project that the Offeror developed for the user identified. Please place an “X” to indicate the rating for each area below. This information will be kept CONFIDENTIAL (please print or type):

a. Quality of Workmanship?

b. Adequacy of the QC Plan?

c. Implementation of the QC Plan?

d. Quality of the QC Document?

e. Storage of Materials?

f. Adequacy of Material?

g. Adequacy of Submittals?

h. Adequacy of QC Testing?

i. Adequacy of As-Builts?

j. Use of Specified Materials?

k. Identification/Corrections of Deficient Work in a Timely Manner?

Comments: ______________________________________________________________________________

a. Adequacy of Initial Progress Schedule?

b. Adherence to Approved Schedule?

c. Resolution of Delays?

d. Submission of Required Documentation?

e. Completion of Punchlist Items?

f. Submission of Updated and Revised Progress Schedules?

g. Warranty Response?

Comments: ______________________________________________________________________________

a. Cooperation and Responsiveness?

b. Management of Resources/Personnel?

c. Coordination and Control of Subcontractor(s)?

d. Adequacy of Site Clean-Up?

e. Effectiveness of Job-Site Supervision?

f. Compliance with Laws and Regulations?

g. Professional Conduct?

h. Review/Resolution of Subcontractor’s Issues?

i. Implementation of Subcontracting Plan?

Comments: ______________________________________________________________________________

a. Correction of Noted Deficiencies?

b. Payrolls Properly Completed and Submitted?

c. Compliance with Labor Laws and Regulation with Specific Attention to the Davis-Bacon Act and EEO Requirements?

Comments: ______________________________________________________________________________

a. Adequacy of Safety Plan?

b. Implementation of Safety Plan?

c. Reporting/Correction of Noted Safety Deficiencies?

Comments: ______________________________________________________________________________

a. Overall Rating for Contractor on this Project?

NO

Comments: ______________________________________________________________________________

SECTION C - RESPONDENT INFORMATION

Name / Title ______________________________________________________________________

Signature: _________________________________________ Date: ____________________

Agency/Company: _______________________________________________________________________

Work phone number (including area code): ____________________________________________________

FAX number (including area code): __________________________________________________________

Your role relative to the project/contract: _____________________________________________________ (Administrative Contracting Officer, Inspector, Contract Administrator, Buyer, Quality Assurance Evaluator, Other - explain)

Length of involvement in project/contract: _____________________________________________________

Do you know anyone else who can provide information regarding this Offeror’s performance?

Name: ___________________________________ Phone/Fax: ___________________________________

Name: ___________________________________ Phone/Fax: ___________________________________

THANK YOU FOR YOUR ASSISTANCE IN COMPLETING THIS QUESTIONNAIRE

Section J – Attachment 4 1 20 Apr 2010