Atch 6 - Past Performance Survey Correct.docx
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- Base Roof Repairs Federal contract opportunity
- Solicitation number
- FA4427-11-R-0102
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DEPARTMENT OF THE AIR FORCE
60TH CONTRACTING SQUADRON (AMC)
3 January 2011
MEMORANDUM FOR (Contractor please add reference information)
FROM: 60 CONS/LGCA
350 Hangar Ave Bldg 549 Travis AFB, CA 94535-2632
SUBJECT: Request for Past Performance Questionnaire Information for FA4427-11-R-0102, Base Roof Repairs, at Travis AFB, CA
1. You have been identified as a reference point of contact for past and/or present performance evaluation of the firm listed on the attached questionnaire form. This firm is currently interested in providing a proposal for a Installation of Crash Rated Gate at Main Gate, at Travis AFB, CA.
2. Please complete the attached survey questionnaire and return no later than 19 Feb 2011. Please e-mail the survey back to Jose Hernandez at jose.hernandez.17@us.af.mil and send a courtsey copy to Ms. Marguerite Holbein marguerite.holbein@travis.af.mil. You may fax the questionnaire to (707) 424-5189.
3. If you have any questions, please contact Jose Hernandez at (707) 424-7771 or Ms. Marguerite Holbein at (707) 424-7765.
4. Your information MUST be submitted by 19 Feb 2011. Your expedient attention regarding this matter is greatly appreciated. Thank you in advance.
| VALLARIE V. KILKENNY |
| Contracting Officer |
PRESENT AND PAST PERFORMANCE QUESTIONNAIRE
Solicitation Number FA4427-10-R-0110 Install Crash Rated Gate at Main Gate, at Travis AFB, CA
When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and 3.104
A. GENERAL INFORMATION: Contractor please complete block A before sending to your reference.
Contractor’s Name:
Address:
Telephone Number:
Fax Number:
Point of Contact:
Project Title or Brief Description of Work:
Contract Number Provided by Offeror: Dollar Amount: $
Contract Period or Dates of Performance Provided by Offeror:
Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.
Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.
B. RESPONDENT INFORMATION:
Name of Respondent:
Title: Company:
Address:
Telephone Number:
Fax Number:
Email Address:
C. Email Completed Questionnaire Form Not Later Than 3 Feb 2011
To:
Jose Hernandez Ms. Marguerite Holbein Email: jose.hernandez-02@travis.af.mil ____ Email: marguerite.holbein@travis.af.mil
PERFORMANCE INFORMATION: Circle the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.
Based on the offeror’s performance record:
| 6 |
| Exceptional (E) |
| Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective. |
| 5 |
| Very Good (VG) |
| Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective. |
| 4 |
| Satisfactory (S) |
| Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory. |
| 3 |
| Marginal (M) |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed 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. |
| 2 |
| Unsatisfactory (U) |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective. |
| 1 |
| Neutral (N) |
| Performance was not observed or not applicable to the current effort being reported against. |
The Contractor…
N U M S VG E
PERFORMANCE/PROGRAM MGMT
1. Upon award the contractor was timely in 1 2 3 4 5 6 N/A fulfilling contract requirements (submitting documents, starting work, submitting materials & acknowledgements, etc)?
2. Cooperated with owner/government personnel 1 2 3 4 5 6 N/A after award.
3. Demonstrated ability to hire, maintain & 1 2 3 4 5 6 N/A replace if necessary, qualified personnel during the contract period.
4. Provided experienced employees with the 1 2 3 4 5 6 N/A technical & administrative abilities to meet contract requirements.
5. Provided material submittals in accordance 1 2 3 4 5 6 N/A with the contract requirements.
6. Provided payrolls in a timely manner. 1 2 3 4 5 6 N/A
7. Maintained a single point of contact to 1 2 3 4 5 6 N/A manage and resolve problems.
8. Provided adequate employee supervision. 1 2 3 4 5 6 N/A
9. Company headquarters participated in solving 1 2 3 4 5 6 N/A significant local problems.
10. Corrected deficiencies in timely manner & 1 2 3 4 5 6 N/A pursuant to their quality control procedures.
11. Met established turn around times 1 2 3 4 5 6 N/A for required periodic contract reports, etc.
12. Identified risks/problems as they occurred. 1 2 3 4 5 6 N/A
13. Suggested alternative approaches to problem. 1 2 3 4 5 6 N/A
14. Was responsive to contract changes. 1 2 3 4 5 6 N/A
15. Effectively managed sub-contractor 1 2 3 4 5 6 N/A efforts.
16. Do you have any reservations about Yes ( ) No ( ) N/A ( ) having this contractor perform another contract for you? (If yes, please explain under “remarks”.)
17. Rate the contractor’s overall performance 1 2 3 4 5 6 N/A under this contract.
EMPLOYEE RETENTION
1. Demonstrated ability to retain a qualified 1 2 3 4 5 6 N/A workforce.
INVOICING & PROGRESS REPORTS
1. Provided accurate and timely invoices. 1 2 3 4 5 6 N/A
2. Provided accurate and timely progress reports 1 2 3 4 5 6 N/A
ORGANIZATION
1. Has demonstrated good organizational 1 2 3 4 5 6 N/A structure and accountability.
2. If there were problems with the on site supervision, Yes ( ) No ( ) N/A ( ) were you able to easily resolve those problems with the company’s management? (Please explain under “remarks”.)
3. Are you aware of any documented organizational Yes ( ) No ( ) N/A ( ) deficiencies with the contractor?
(If yes, please explain under “remarks”.)
LEGAL
1. Are you aware of any legal problems experienced by Yes ( ) No ( ) N/A ( ) the contractor? (Please explain under “remarks”.)
2. Are you aware of any verified ethical problems Yes ( ) No ( ) N/A ( ) experienced by the contractor? (Please explain under “remarks”.)
GOVERNMENT CONTRACTS ONLY
1. Was the contractor ever issued a cure notice Yes ( ) No ( ) N/A ( ) or show cause? If yes, explain outcome in “remarks”.
2. Has the contract been partially or completely terminated Yes ( ) No ( ) N/A ( ) or is the contract pending termination?
2a. If you answered “YES” to question #2, please explain under “remarks”.
3. Has an election ever been made to not exercise an option due to contractor’s performance. Yes ( ) No ( ) N/A ( ) If yes, explain in “remarks”.
3. Was there any specific delivery order that had problems?
(please explain under “remarks” Yes ( ) No ( ) N/A ( )
NARRATIVE SUMMARY
1. What were the contractor’s greatest strengths in performance of the contract?
2. What were the contractor’s greatest weaknesses in performance of the contract?
Please add any additional comments concerning this contractor’s performance.
Remarks:
Please provide the Name, Organization, e-mail and phone number of the Inspector on this contract in the blocks below.
| _________________ | __________________ | _______________________ | _____________________ |
| (Name) | (Organization) | (E-mail) | (Phone Number) |
FA4427-11- R-0102 Attachment #6 Page 1 image1.emf
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