Past_Performance_Questionnaire_used.rtf

Past 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: ___________________________________

Briefly explain how the work is relevant to this requirement:_____________________________________________________________

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: _____________________ _____________________________________ Email Address: ________________________ Fax Number: ___________________________

C. FAX COMPLETED SURVEY FORM TO: ATTN: Danny Howell at (609)754-4730 or send via Email to danny.howell.3@us.af.mil

D PERFORMANCE INFORMATION: Choose the appropriate rating on the scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, and N/A) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS Of Marginal, Unsatisfactory and N/A.

RATING

DESCRIPTION

Exceptional Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective Very Good Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were efffective.

Satisfactory Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal Performance does not meet some contractual requirements. The contractual performance being assessed reflect a serious problem for which the contractor has not yet identified corrective actions or the contractor’s actions appear only marginally effective or were not fully implemented.

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

N/A Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

The contractor:

E V S M U N/A 1.

Provided pest control services for office and food service facilities for at least one year.

2.

Provided experienced managers and supervisors with the technical abilities needed to meet contract requirements.

3.

Adhered to plans, regulations and instructions concerning pest management

4.

Provided and adhered to their quality control plan.

5.

Performed emergency services when needed within 2 hours of notification.

6.

Established and maintained schedule for pest management services

7.

Adhered to instructions and directions regarding the use and disposal of Hazardous chemicals.

8.

Has the contractor ever received a violation or penalty for non-compliance with federal or state directives concerning pest management. If yes please explain. CIRCLE: YES NO

9.

Did the contractor remain current on all training requirements during the contract period.

CIRCLE: YES NO

10.

Corrected deficiencies in a timely manner in accordance with instructions.

11.

Provided timely resolution of all contract discrepancies.

12.

Displayed initiative to solve problems.

13.

Cooperated with Government personnel after award.

14.

How would you rate the contractor's overall performance?

15.

Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES/ NO

16.

Would you award another contract to this contractor? If not, explain in “remarks.”

YES /NO

17.

Is the contractor rated in CPARS?

YES/NO

Place an “X” in the appropriate column using the definitions matrix above.

Comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________