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MEMORANDUM FOR (Contractor please add reference information)
FROM: 19 CONS/LGCA
| 642 THOMAS AVENUE |
| LITTLE ROCK ARB AR 72099-4971 |
SUBJECT: Request for Past Performance Questionnaire Information for FA4460-11-R-0021, Sustain/Repair Base Supply Roof B-450
1. Your 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 the above reference project.
2. Please complete the attached survey questionnaire. You should e-mail the survey back to Samuel Hevrin at samuel.hevrin@us.af.mil. Also send a courtesy copy to Barry G. Jundt at barry.jundt@us.af.mil. You may fax the questionnaire to (501) 987-8119. If you have any questions, please contact SrA Samuel Hevrin at (501) 987-3448 or Barry G. Jundt at (501) 987-3853. Your information MUST be submitted by 26 Aug 2015 @ 2:00PM LOCAL (CST). Your expedient attention regarding this matter is greatly appreciated. Thank you in advance.
| JESSE L. CHRISTY |
| Contracting Officer |
1. Atch Past and Present Performance Questionnaire
PAST AND PRESENT PERFORMANCE QUESTIONNAIRE
A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:
Contractor’s Name: ____________________ Telephone Number: ____________________ Address: __________________________ Fax Number: _________________________ __________________________ Point of Contact: ______________________
| __________________________ |
| __________________________ |
Project Title and Brief Description of Work: _____________________________________*
Contract Number Provided by Offeror: ___________________ Dollar Amount: ________*
Contract Period or Dates of Performance Provided by Offeror: ______________________* Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.
* 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.
B. RESPONDENT INFORMATION:
Name of Respondent: _____________________ Title: ____________________________
| Address: _____________________ | Telephone Number: ___________________ _____________________________ | Fax Number: | _____________________ |
| _____________________________ | Email Address: _____________________ | | |
C. FAX COMPLETED SURVEY FORM TO: __________________________________
D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (SUBC, SATC, LC, NC, and UC) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF LC or NC.
| Exceptional |
| Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
| Neutral |
Performance meets/met 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.
| Performance meets/met 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. |
| Performance meets/met 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. |
| Performance does not meet/did 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. |
| Performance does not meet/did 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. |
Performance was not observed or not applicable to the current effort being reported against.
CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________
Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.
Place an “X” in the appropriate column using the definitions matrix above.
| The contractor: |
| SUBC |
| SATC |
| LC |
| NC |
| UC |
| 1. |
| Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements. |
| 2. |
| Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period. |
| 3. |
| Delegated authority to project managers and supervisors commensurate with contract requirements. |
| 4. |
| Home office participated in solving significant local problems. |
| 5. |
| Followed approved quality control plan. |
| 6. |
| Provided effective quality control and/or inspection procedures to meet contract requirements. |
| 7. |
| Corrected deficiencies in timely manner and pursuant to their quality control procedures. |
| 8. |
| Provided timely resolution of contract discrepancies. |
| 9. |
| Identified problems as they occurred. |
| 10. |
| Suggested alternative approaches to problems. |
| 11. |
| Displayed initiative to solve problems. |
| 12. |
| Developed realistic progress schedules. |
| 13. |
| Met established project schedules. |
| 14. |
| Provided timely resolution of warranty defects. |
| 15. |
| Was responsive to contract changes. |
| 16. |
| Provided adequate project supervision. |
| 17. |
| Obtained consent of surety for increases in bonding as work-in-progress increased. |
| 18. |
| Paid subcontractors/suppliers in a timely manner. |
| 19. |
| Provided accurate and complete line item cost proposals including all aspects of work required for each task. |
| 20. |
| Cooperated with Government personnel after award. |
| 21. |
| How would you rate the contractor's overall performance? |
| 22. |
| Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.” |
Yes No
| 23. |
| Would you award another contract to this contractor? If not, explain in “remarks.” |
| Yes |
| No |
| 24. |
| Is the contractor rated in CPARS? |
| Yes |
| No |
CONTRACTOR’S NAME: ___________________ CONTRACT NUMBER __________
Remarks:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
