Past Performance Survey Attach 3.doc

FA419-11-R-0108

Attachment #3

Fax Coversheet

97 Contracting Squadron

Altus AFB, OK From:

DSN 866-5138

DSN 866-7545

Date:

Solicitation FA4419-11-R-0108

CC:

MACROBUTTON CheckIt ( Urgent X For Review MACROBUTTON CheckIt ( Please Comment MACROBUTTON CheckIt ( Please Reply MACROBUTTON CheckIt ( Please Recycle ( Comments:

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

When filled in this document is source selection sensitive information iaw FAR 3.104

7 Nov 2007

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: ________________________________________________________________________________

B. Cage Code of contractor contract was awarded to: ________________________________________

C. Contract number: __________________________________________________________________

D. Contract type: _____________________________________________________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance: ______________________________________________________________

G. Initial contract cost: $________________________________________________________________

H. Current/final contract cost: $___________________________________________________________

I. Reasons for differences between initial contract cost and final contract costs: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

J. Description of service provided: __________________________________________________________________________________

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name: __________________________________________________________________________________

B. Customer or agency description (if applicable): __________________________________________________________________________________

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name: __________________________________________________________________________________

B. Evaluator's title: __________________________________________________________________________________

C. Evaluator's phone/fax number: __________________________________________________________________________________

Number of years evaluator worked on subject contract: __________________________________________

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE

PERFORMANCE LEVEL

E EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD- The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N

NOT APPLICABLE - Unable to provide a score.

QUALITY

Q1. Conformance to contract requirements, specifications and standards of good workmanship (e.g., commonly accepted technical, professional, environmental, or safety and health standards).

Q2. Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements.

SCHEDULE

T1. Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

T2. Ability to successfully respond to emergency and/or surge situations

T3. Adherence to the required delivery schedules.

BUSINESS RELATIONS

B1. Effectiveness of overall contract management (including ability to effectively lead, manage and control the program)

B2. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes)

CUSTOMER SATISFACTION

C1. Has the contractor demonstrated unreasonable and uncooperative behavior in customer complaints.

C2. Is the contractor flexible in satisfying the requirements of the customer.

C3. To what extent did the contractor provide prompt and courteous service when

Responding to customer complaints.

RESPONSIVENESS

R1. Rate the contractor’s ability to meet specific response times and scheduled time frames for completion of specific tasks.

R2. Rate the contractor’s upper level management responsiveness.

R3. To what extent has the contractor responded in a timely manner to emergency or immediate service requirements.

2. Please discuss every question you evaluated as E (Exceptional), M (Marginal) or U (Unsatisfactory) (use additional sheets, if necessary).

3. Government Contracts Only: Has/was this contract been partially or completely terminated for default or are there any pending terminations?

Yes___ Default___ Pending Terminations___

No ___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).

4. Contractor Financial Responsibility:

Has the contractor had issues with late/nonpayment of payroll?

If yes, please explain (e.g., frequency of occurrences, conditions surrounding incidents, outcome, etc).

Has the contractor had issues with non payment of sub-contractors?

If yes, please explain (e.g., frequency of occurrences, conditions surrounding incidents, outcome, etc).

Has the contractor had The Department of Labor involved with any labor issues?

If yes, please explain (e.g., frequency of occurrences, conditions surrounding incidents, outcome, etc).

SECTION 5: NARRATIVE SUMMARY

What were the contractor’s greatest strengths in the performance of the contract?

What were the contractor’s greatest weaknesses in the performance of the contract?

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

Please provide any additional comments concerning this contractor’s performance, as desired.

SECTION 6: OVERALL RATING

Considering all of the information provided above, please rate the contractor's performance overall.

Exceptional Very Good Satisfactory Marginal Unsatisfactory Not Applicable

Evaluator’s Signature

Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire NLT 1 day prior to bid due date (5September 2011):

Mailing Address:

97th Contracting Squadron, LGCB

303 J Ave, Bldg 302

Altus AFB, OK 73523-5132 Or use fax coversheet to:

580 481-5138

DSN 866-5138