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Solicitation # FA4484-14-R-0020
Note: Include contractor’s name and contract number on each page of the Past and Present Performance Questionnaire A. GENERAL INFORMATION: The offeror will enter this information and submit questionnaire to the references and the references will return to the contact shown below. No questionnaires will be accepted from the offeror.
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: ATTN: 1 Lt Kevin Restrepo at (609)754-4642 or send via Email to kevin.restrepo.1@us.af.mil
D PERFORMANCE INFORMATION: Choose the appropriate rating on the scale (Exceptional, Good, Satisfactory, Marginal, Unsatisfactory, and Neutral) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS Of Marginal, Unsatisfactory and Neutral.
| Exceptional |
| Performance meets contractual requirements with many exceeded to the customers benefit. The contractual performance of the 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. |
| Good |
| Performance meets contractual requirements with some exceeded to the customer’s benefit. The contractual performance of the elements or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective. |
| Satisfactory |
| Performance does not meet some 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. |
| Marginal |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects 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. |
| Unsatisfactory |
| Performance does not meet most contractual requirements and recovery is not likely in 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. |
| Neutral |
| Performance was not observed or not applicable to the current effort being reported against. |
Place an “X” in the appropriate column using the definitions matrix above.
| The contractor: |
| E |
| G |
| S |
| M |
| U |
| N |
| 1. |
| Provided experienced personnel with the abilities needed to meet contract requirements. |
| 2. |
| Demonstrated ability to hire, maintain, and if necessary, replace qualified personnel during contract period. |
| 3. |
| Provided the required maintenance, repair and service per manufacture’s recommendations and in accordance with industry standards. |
| 4. |
| Responded to service calls in a timely manner and coordinated repairs with proper personnel |
| 5. |
| Identify the specific type of fire suppression system to which the contactor performed maintenance and repair services. |
| 6. |
| Provided complete written reports in accordance with direction provided by contracting officer representative or in accorance with the contract. |
| 7. |
| Demonstrate ability to meet timelines |
| 8. |
| Identified problems as they occurred. |
| 9. |
| Displayed initiative to solve problems. |
| 10. |
| Cooperated with Government personnel after award. |
| 11. |
| How would you rate the contractor's overall performance? |
| 12. |
| Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.” |
YES/NO
| 13. |
| Would you award another contract to this contractor? If not, explain in “remarks.” |
YES/NO
| 14. |
| Is the contractor rated in CPARS? |
| YES/NO |
Remarks:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________