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Attachment #6
PAST AND PRESENT PERFORMANCE QUESTIONNAIRE.
WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION INFORMATION IN ACCORDANCE WITH FAR 3.104
PART I: OFFEROR COMPLETE BELOW:
Contractor (Name, Address, and Zip code):
| _____________________________________ |
| _____________________________________ |
| _____________________________________ |
Contract Number: ______________________________________
Program/Project Title: ________________________________________________
Type of Contract: Fixed Price ___ Cost Reimbursement ____ Other ____ (Explain)
Description, location, and relevancy of work.
Performance Period: ____________________________________ Date of Award: ______________________________________ Original Contract Dollar Value: _____________________________ Current/Completed Contract Dollar Value: _________________________ If amounts for 8 and 9 above are different, provide a brief explanation for the reason.
Contract Completion Date (including extension): ___________________
Point of Contact Information:
Procuring/Administrative Contracting Officer:
Name: Phone:________________________________
Address: Fax:__________________________________
E-mail:________________________________
PART II. RESPONDENT/GOVERNMENT OFFICIAL’S INFORMATION AND PERFORMANCE EVALUATION
You have been provided as a reference in response to the solicitation for a contract to provide for IDIQ for Simplified Acquisition of Base Engineer Requirements (SABER). In order for the government to evaluate the past performance of the firm providing you as a reference, please complete this questionnaire and forward to the 55th Contracting Squadron in accordance with the instructions listed below. If any information above in Part I is inaccurate, please make corrections.
The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable.
Past Performance Questionnaire due 11 May 2010, no later than 4:00pm CST.
FAX to: (402) 232-5682 or DSN 272-5682
E-MAIL to: enrique.gonzalez@offutt.af.mil
| Mail to: | 55th Contracting Squadron/LGCA |
| Attn: SSGT Enrique L. Gonzalez |
| 101 Washington Square |
| Offutt AFB, NE 68113 |
POC: SSGT Enrique L. Gonzalez, (402) 232-5682 or DSN 272-5682
Respondent/Government Official’s Information
NAME: __________________________________________________________
POSITION/TITLE: _________________________________________________________
ADDRESS: _________________________________________________________________
TELEPHONE NUMBER: __________________________FAX: _______________________
E-MAIL: ______________________________________________________
Relationship and time involved with Contractor:
Date questionnaire was completed: ________________________
The following chart depicts the RATINGS that are to be used to evaluate the contractor’s performance:
| NO CONFIDENCE |
| LIMITED CONFIDENCE |
| SATISFACTORY CONFIDENCE |
| SUBSTANTIAL CONFIDENCE |
| UNKNOWN CONFIDENCE |
| Based on the offeror’s performance record, substantial doubt exists that the offeror will successfully perform the required effort. |
| Based on the offeror’s performance record, the Government has confidence the offeror will successfully perform the required effort. Normal contractor emphasis should preclude any problems. |
| Based on the offeror’s performance record, the Government has significant confidence the offeror will successfully perform the required effort. |
| Based on the offeror’s performance record, the Government has high confidence the offeror will successfully perform the required effort. |
| No performance record identifiable (See FAR 15.305(a)(2)(iii) and (iv)) |
Request that additional comments be provided in the space at the end of each subfactor. If more space is needed, use the back of the questionnaire or attach additional pages. Be sure to identify your continued narration with the respective line number.
CONTRACT WRITTEN BY: ____________________________________
CONTRACT NUMBER: _______________________________________
POINT OF CONTACT: ________________________________________
NAME OF PRIME CONTRACTOR: _____________________________
GENERAL BUSINESS PRACTICES:
| 1. Contractor identified problems as they occurred; suggested realistic approaches to problems; displayed initiative to solve problems and performed as a "Team Member". |
| 1 |
| 2 |
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| 4 |
| 5 |
| N |
| 2. Contractor realigned performance schedules to meet customer needs when changes occurred. |
| 1 |
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| 4 |
| 5 |
| N |
| 4. Contractor provided experienced/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements. |
| 1 |
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| 4 |
| 5 |
| N |
| 5. Contractor hired, maintained, and replaced as necessary, qualified personnel and sub-contractors/suppliers. |
| 1 |
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| 5 |
| N |
| 6. Contractor hired quality sub-contractors and effectively managed and coordinated their work. |
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| 5 |
| N |
| 7. Contractor maintained appropriate staffing levels (number/qualifications) |
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| 5 |
| N |
| 8. Home office participated in solving significant local problems. |
| 1 |
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| N |
9. Contractor maintained adequate bonding throughout the contract.
Additional Comments: (General Business Practices)
TASK ORDER:
| 1. Contractor provided complete, supportable, accurate, and reasonable cost/price proposals that met the requirements of the project or modification. |
| 1 |
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| N |
| 2. Contractor controlled costs and/or design projects or modifications within the magnitude specified |
| 1 |
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| N |
| 3. Contractor submitted proposals that accurately represented the work required/requested. |
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| N |
| 4. Were modifications required due to contractor design errors? |
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| N |
| 6. Contractor’s initial estimates for quantities were fair and reasonable. (They were not over-inflated nor were they underestimated) |
| 1 |
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| N |
| 7. Thorough site investigation and field analysis was provided in designs |
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| N |
| 8. Plans were clear and sufficiently detailed. |
| 1 |
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| N |
| 9. Plans/Specs were accurate and coordinated with CE personnel and subcontractors. |
| 1 |
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| N |
Additional Comments: (Task Order)
SITE MANAGEMENT /SUPERINTENDENT:
| 1. Contractor promptly resolved problems, ensuring compliance with contract requirements and safety regulations. |
| 1 |
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| N |
| 2. Contractor ensured the site manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule. |
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| N |
| 3. Contractor ensured the site manager was consistently present on site when work was performed. |
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| N |
| 4. Contractor completed all contract work prior to requesting a final inspection. Left no major discrepancies. |
| 1 |
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| 5 |
| N |
| 5. Contractor provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| N |
| 6. Contractor showed initiative solving problems. |
| 1 |
| 2 |
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| 5 |
| N |
Additional Comments: (Site Management)
TIMELY PERFORMANCE:
| 1. Contractor met established project schedules to complete the project on time. |
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| 5 |
| N |
| 2. Contractor submitted the progress schedule and interim progress reports in a timely manner. |
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| N |
| 3. Contractor provided timely cost/design proposals. |
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| N |
| 4. Contractor provided on-time submittals. |
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| N |
| 5. Contractor provided timely resolution on all punch list items. |
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| N |
| 6. Contractor was proactive in keeping you informed of schedule changes if they were going to occur. |
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| N |
| 7. Contractor responded to emergency requirements in a timely manner. |
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| N |
| 8. Contractor met the required performance period of the contract? |
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| N |
| 9. Designs and estimates were prepared and submitted within the timeframes identified in the contract? |
| 1 |
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| 5 |
| N |
| 10. Responded to warranty issues within the timeframes specified in the contract. |
| 1 |
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| N |
| 11. Subcontractor payments were timely. |
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| N |
| 12. Contractor provided payrolls in a timely manner. |
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| N |
| 13. Contractor provided timely responses to Contracting Officer queries. |
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| N |
Additional Comments: (Timely Performance)
QUALITY CONTROL/WORKMANSHIP:
| 1. Contractor provided effective quality control and inspection procedures, which resulted in a quality finished project. |
| 1 |
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| 5 |
| N |
| 2. Contractor completed all work with good workmanship and in conformance with the specifications, resulting in minimal, if any, punch-list items |
| 1 |
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| N |
| 3. Contractor identified risks/problems as they occurred. |
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| N |
| 4. Contractor As-Built drawings were accurate, to include all change order corrections, and submitted when required. |
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| N |
| 5. Contractor properly submitted, delivered, and stored required materials? |
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| N |
Additional Comments: (Quality Control)
AREAS OF COMPETENCY (RS MEANS Divisions)
1. How was the contractor's/subcontractors workmanship and proficiency in completing work in the area of:
| 6. Demolition |
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| 5 |
| N |
| 9. Communications |
| 1 |
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| N |
| 10. Electrical |
| 1 |
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| 5 |
| N |
| 11. Mechanical |
| 1 |
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| 5 |
| N |
Additional Comments: (Areas of Competency))
CUSTOMER SATISFACTION:
| 1. Contractor maintained a professional working relationship. |
| 1 |
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| 5 |
| N |
| 2. Contractor was reasonable and cooperative in resolving customer complaints. |
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| N |
| 3. Contractor was flexible in responding to customer requirements. |
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| N |
| 4. Customer would have no reservations in awarding another contract to the Contractor. |
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| N |
Additional Comments: