Attachment 8 Past and Present Performance Questionaire.pdf

SOLICITATION NUMBER: FA4497-11-R-0013

CONTRACT NUMBER:

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

(24 March 2011) (Attachment 8)

FOR OFFICIAL USE ONLY

GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: _______________________________________________________ Address: ______________________________ Telephone Number: _________________ ______________________________________ Point of Contact: ___________________

Contractor Performed as the Prime Contractor, the Sub-Contractor.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ___________________________

Address: _______________________________ Telephone Number: ___________________ ______________________________________ Fax Number:________________________ ______________________________________ E-Mail:_____________________________

C. FAX COMPLETED SURVEY FORM TO: 436 Contracting Squadron LGCA Attn:

Phone No.

OR

D. E-MAIL COMPLETED SURVEY FORM TO: __________________________________

F. CONTRACT NO: ___________________________________________________________

G. CONTRACT STATUS: (% complete, complete, just awarded, etc.)

H. AWARD AMOUNT: ________________________________________________________

I. TYPE OF CONTRACT: _____________________________________________________

H. PERFORMANCE PERIOD: From ___________________ To _____________________

I. BRIEF DESCRIPTION OF CONTRACT REQUIREMENTS:

D. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation.

1 2 3 4 5 6 Unsatisfactory Marginal None Satisfactory Very Good Exceptional Performance did not meet most contractual requirements.

There were serious problems and the contractor’s corrective actions were ineffective.

Performance did not meet some contractual requirements.

There were problems, some of a serious nature, for which corrective action was only marginally effective.

No record of past performance or the record is inconclusive.

Performance met contract requirements.

There were some minor problems and corrective actions taken by the contractor were satisfactory.

Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems which the contractor resolved in a timely, effective manner.

Performance met all contract requirements and exceeded many to the government’s benefit.

Problems, if any, were negligible and were resolved in a timely, highly effective manner.

The contractor:

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

1 2 3 4 5 6 NA

2. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

1 2 3 4 5 6 NA

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

1 2 3 4 5 6 NA

4. Home office participated in solving significant local problems.

1 2 3 4 5 6 NA

5. Followed approved quality control plan. 1 2 3 4 5 6 NA

6. Provided effective quality control and/or inspection procedures to meet contract requirements.

1 2 3 4 5 6 NA

7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

1 2 3 4 5 6 NA

8. Provided timely resolution of contract discrepancies. 1 2 3 4 5 6 NA

9. Identified risks/problems as they occurred. 1 2 3 4 5 6 NA

10. Suggested alternative approaches to problems. 1 2 3 4 5 6 NA

11. Displayed initiative to solve problems. 1 2 3 4 5 6 NA

12. Developed realistic progress schedules. 1 2 3 4 5 6 NA

13. Met established project schedules. 1 2 3 4 5 6 NA

14. Provided timely resolution of warranty defects. 1 2 3 4 5 6 NA

15. Was responsive to contract changes. 1 2 3 4 5 6 NA

16. Provided adequate project supervision. 1 2 3 4 5 6 NA

17. Obtained consent of surety for increases in bonding as work-in-progress increased.

1 2 3 4 5 6 NA

18. Paid subcontractors/suppliers in a timely manner. 1 2 3 4 5 6 NA

19. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

1 2 3 4 5 6 NA

20. With respect to the safety plan, the contractor:

a. Followed the approved safety plan. 1 2 3 4 5 6 NA

b. Had no significant safety problems at the job site. 1 2 3 4 5 6 NA

21. The contractor met contractual requirements for the following work elements:

NA

a. Constructed pavements and drainage structures to the specified grade and alignment requirements

1 2 3 4 5 6 NA

b. Constructed pavement sections to the specified thickness, density, and surface smoothness requirements

1 2 3 4 5 6 NA

c. Performed specified curing and protection of concrete pavement surfaces

1 2 3 4 5 6 NA

d. Mobilized and completed work in a timely manner to work orders issued under the “On Call” or Indefinite Delivery Indefinite Quantity (IDIQ) contract

1 2 3 4 5 6 NA

22. Cooperated with Government personnel after award. 1 2 3 4 5 6 NA

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

Y E S

N O

24. Would you award another contract to this contractor?

If not, explain in “remarks.”

Y E S

25. Has contractor demonstrated a history of environmental compliance with respect to erosion and sediment control on construction sites? If not, explain in “remarks.”

Y E S

Remarks:______________________________________________________________________