Attachment 6 Past Performance Survey.doc

PRESENT AND PAST PERFORMANCE QUESTIONNAIRE

Solicitation Number FA4479-10-R-0002

SABER at Joint Base Lewis-McChord, WA

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 (Please correct any information below known to be inaccurate):

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 5 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 June 2, 2010 To:

Terry Seaverns Victoria Ghent

Terry.Seaverns@mcchord.af.mil Victoria.Ghent@mcchord.af.mil D. 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:

TABLE 3-PERFORMANCE CONFIDENCE ASSESSMENTS

CONTRACTOR’S NAME: _______________________ CONTRACT NUMBER ________________

NC

LC

UC

SC

SUC

PERFORMANCE/PROGRAM MGMT

1. Upon award the contractor was timely in

N/A fulfilling contract requirements (submitting documents, starting work, submitting materials

& acknowledgements, etc)?

2. Cooperated with government personnel

N/A after award.

3. Demonstrated ability to hire, maintain &

N/A replace if necessary, qualified personnel during the contract period.

4. Provided experienced employees with the

N/A technical & administrative abilities to meet contract requirements.

5. Provided material submittals in accordance

N/A with the contract requirements.

6. Provided payrolls in a timely manner.

N/A

7. Maintained a single point of contact to

N/A manage and resolve problems.

8. Provided adequate employee supervision.

N/A

9. Company headquarters participated in solving

N/A significant local problems.

10. Corrected deficiencies in timely manner &

N/A pursuant to their quality control procedures.

11. Met established turnaround times

N/A for required periodic contract reports, etc.

12. Identified risks/problems as they occurred.

N/A

13. Suggested alternative approaches to problem.

14. Was responsive to contract changes.

15. Effectively managed sub-contractor

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

N/A under this contract.

ORGANIZATION

1. Has demonstrated good organizational

N/A structure and accountability.

2. If there were problems with the onsite supervision, 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

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

N/A ( ) experienced by the contractor? (Please explain under “remarks”.)

GOVERNMENT CONTRACTS ONLY

1. Was the contractor ever issued a cure notice

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.

N/A ( ) If yes, explain in “remarks”.

3. Was there any specific task order that had problems?

(please explain under “remarks”

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 Project Manager or Project Inspector on this contract in the blocks below.

(Name) (Organization) (E-mail) (Phone Number)

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Solicitation FA4479-10-R-0002