SURVEY.pdf

Airfield & Heavy Duty Paving IDC Solicitation Number: FA4497-11-R-0007 Project Number: 111099 Contract Number:

21 March 2011 Attachment 8

For Official Use Only

PAST AND PRESENT PERFORMANCE SURVEY

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

Contractor’s Name: ________________________________________________________ Address: ______________________________ Telephone Number: __________________ ______________________________________ 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.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ___________________________

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

C. FAX COMPLETED SURVEY FORM TO: 436 Contracting Squadron LGCA Attention: John M. Lynch Phone Number: (302) 677-2905

OR

E-MAIL COMPLETED SURVEY FORM TO: John.lynch.16@us.af.mil

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 appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

E G S M U N Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or 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.

Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets 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.

does not meet some contractual requirements.

The contractual performance of the element or sub-element being assessed reflects a 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.

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

was not observed or not applicable to the current effort being reported against.

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

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

The contractor: E G S M U N

For Official Use Only

The contractor: E G S M U N

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

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

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

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

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

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

8. Provided timely resolution of contract discrepancies.

9. Identified risks/problems as they occurred.

10. Suggested alternative approaches to problems.

11. Displayed initiative to solve problems.

12. Developed realistic progress schedules.

13. Met established project schedules.

14. Provided timely resolution of warranty defects.

15. Was responsive to contract changes.

16. Provided adequate project supervision.

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

18. Paid subcontractors/suppliers in a timely manner.

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

20. Cooperated with Government personnel after award.

21. How would you rate the contractor's overall performance?

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

a. Followed the approved safety plan.

b.

Had no significant safety problems at the job site.

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

The contractor: E G S M U N a.

Previous multi-year Indefinite Delivery Indefinite Quantity(IDIQ)or “On Call” type contracts b.

Previous airfield construction contracts involving construction of airfield and heavy duty hot-mix, hot-laid, bituminous concrete and Portland cement concrete pavements c.

Maintenance and repair of airfield pavements including joint sealling and concrete spall repair d.

Construction of storm drainage inlets, manholes, and storm sewer pipe

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

YES/NO

25. Would you award another contract to this contractor?

If not, explain in “remarks.”

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

27. Is the contractor rated in CPARS? YES/NO

CONTRACTOR’S NAME: ___________________ CONTRACT NUMBER __________

Remarks:______________________________________________________________________