Attachment_3__Past_Performance_Questionnaire.pdf

FA4486-18-R-0001

Attachment 3

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION:

The individual most knowledgeable of the contractor’s day-to-day operations should complete this survey.

However, this individual is encouraged to supplement his or her knowledge with the judgment of others within his or her organization. Please complete the questionnaire as thoroughly as possible by indicating your ratings and providing comments, wherever applicable. Please print neatly and submit all information in the English language. Follow up phone calls may be conducted by the contracting officer to ensure the accuracy of this questionnaire.

Contractor’s Name: _____________________ Telephone Number: ____________________ Address: _____________________________ Fax Number: _________________________ _____________________________ Point of Contact: ______________________

Project Title and Detailed Description of Work:

Contract Number: ___________________ Dollar/Euro Amount: ___________

Contract Period or Dates of Performance: _________________________

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

B. RESPONDENT INFORMATION:

Name of Respondent: _________________________ Title: ___________________________

Address: _____________________ Telephone Number: _____________________

_____________________________ Fax Number: _________________________

_____________________________ Email Address: _________________________

C. PLEASE E-MAIL THE COMPLETED SURVEY TO: andrea.silva.1.pt@us.af.mil and

A. PERFORMANCE INFORMATION: Please indicate your rating for the contractor’s performance by circling or placing an “X” over the appropriate code using the performance evaluation scale below. Ratings are defined as follows:

O A S M U

Outstanding Above Average Satisfactory Marginal Unsatisfactory

Performance meets contractual requirements and exceeds many to the Government’s benefit.

The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements and exceeds some to the Government’s benefit.

The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

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

Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner.

The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

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

Quality: O A S M U

1 Quality of Workmanship

2 Adequacy of the Quality Control Plan

3 Implementation of the Quality Control Plan

4 Storage of materials

5 Adequacy of Submittals

6 Adequacy of Quality Control Testing

7 Adequacy of As Built Drawings

8 Use of Specified Materials

9 Identification and Correction of Deficient Work

Effectiveness of Management/Business Relations O A S M U

10 Cooperation and Responsiveness

11 Management of Resources/personnel

12 Coordination and Control of Subcontractors (If applicable)

13 Adequacy of Site Cleanup

14 Effectiveness of Job Site Supervision

15 Professional Conduct

16 Review/Resolutions of Subcontractor’s Issues (If applicable)

Quality: O A S M U

17 Implementation of Subcontracting Plan (If applicable)

Timeliness of Performance O A S M U

18 Adequacy of Initial Progress Schedule

19 Adherence to approved Schedule

20 Resolution of Delays

21 Submission of Required Documentation

22 Completion of Punch list Items

23 Submission of Updated and Revised Progress Schedules

24 Warranty Responses

Compliance with Labor Standards O A S M U

25 Compliance with Labor Laws and Regulations

Compliance with Safety Standards O A S M U

26 Adequacy of Safety Plan

27 Implementation of Safety Plan

28 Correction of Noted Deficiencies

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

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

E. GENERAL COMMENT (Choose one of the following and explain your choice in the remarks)

Given what I know today about the contractor’s ability to execute what he promised in the proposal, I definitely would_____ probably would _____ might or might not _____ probably would not _____ definitely would not _____ award to this contractor today given that I had a choice.

Remarks:

Thank you for your prompt response and assistance!

Please e-mail this completed questionnaire to:

andrea.silva.1.pt@us.af.mil and 65CONF.LGC.ALL@us.af.mil or hand deliver to 65th Contracting Flight no later than 10 April 2017.