Atch 2 - Questionnaire.pdf

Attachment 2 PERFORMANCE QUESTIONNAIRE P. 1 of 2

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

GENERAL INFORMATION

A. Offerors shall forward this Attachment for completion to each contract/reference contact the offeror wants the government to consider.

B. Offerors shall ensure each respondent submits a completed survey directly to the Contracting Office, Attn: Joe Pasqualucci, by the closing date of the RFP. (FAX COMPLETED SURVEY FORM TO: 618-256-6012; or E-mail to joe.pasqualucci@scott.af.mil with a copy to rich.hansen@scott.af.mil

Contractor’s Name: ___________________________________________________________

Project Title or Brief Description of Work:

Contract Number : Dollar Amount

C. AGENCY INFORMATION: Work to be performed: Laundry Services

Offeror submitted as:

Prime Contractor Sub-Contractor Key Personnel Teaming/Joint Venture Architect/Engineer

D. RESPONDENT INFORMATION (Person who is completing information):

Name of Respondent: _______________________________ Title: ___________________________________

Address: ___________________________ Telephone Number: ____________________

___________________________________ Fax Number: ____________________________

___________________________________ Email Address: ________________________________

E. FAX/E-MAIL COMPLETED SURVEY AS DIRECTED IN PARA “B” ABOVE

Please call Rich Hansen @ (618) 256-9318 or Joe Pasqualucci @ (618) 256-9288 to confirm receipt of fax mailto:joe.pasqualucci@scott.af.mil mailto:rich.hansen@scott.af.mil

P. 2 of 2

F. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION

FOR ANY RATINGS OF 1 OR 2.

1 2 N 3 4 5

No Confidence Little Confidence Unknown Confidence

Satisfactory Confidence

Significant Confidence High Confidence

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.

The record is inconclusive or without comment or the contractor did not perform this effort.

Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory.

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

Performance met all contract requirements and exceeded many requirements.

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

1 Contractor provided experienced project manager with the technical and administrative abilities needed to meet contract requirements.

1 2 N 3 4 5

2 Contractor was responsive and reasonable to contract changes from the standpoint of timeliness, suggested solutions, and price.

1 2 N 3 4 5

3 Contractor displayed a cooperative attitude with company/government personnel before and after award.

1 2 N 3 4 5

4 Contractor corrected deficiencies in a timely manner and pursuant to their quality control procedures.

1 2 N 3 4 5

5 Were there any claims by subcontractors/suppliers for non-payment. If yes, please explain outcome in “Remarks”.

5 Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in "Remarks."

1 2 N 3 4 5

6 Would you award another contract to this contractor? If not, explain in "Remarks."

YES NO

7 OVERALL ASSESSMENT

8 Overall, on the scale of 1 – 5, how would you rate the contractor being surveyed 1 2 N 3 4 5

Remarks: