Atch_5_Past_Performance_Questionnaire.doc

Solicitation No: FA4608-13-R-0001

CONTRACT NO: _______________

Attachment 5

PAST/PRESENT PERFORMANCE EVALUATION QUESTIONNAIRE

Section A: Contractor Information (to be completed by the contractor prior to mailing or faxing)

Past Performance Questionnaires submitted by the contractor will not be considered. Only Past Performance Questionnaires submitted by their references will be considered as Past Performance Data.

a. Contractor’s Name and Address: ________________________________________

b. Point of Contact: ________________________________________

c. Phone Number: ________________________________________

d. Contract Number: ________________________________________

Contract Type: ________________________________________

FAX Number: _______________________________________

E-mail address: ______________________________________

e. Project Title: ________________________________________

f. Period of Performance: ________________________________________

g. Authorization is hereby granted to provide the information requested in Section B of this questionnaire:

Section B: Respondent Information (to be completed by Past/Present Performance Evaluation respondents).

a. Respondent’s Name and Address: ________________________________________

b. Number of years, evaluator worked on subject contract: ________________________________________

c. Phone Number: ________________________________________

E-mail Address: ________________________________________

FAX Number: ________________________________________

d. Contract Number: ________________________________________

Contract Type: ________________________________________

e. Award Amount: ________________________________________

Final Amount: ________________________________________

f. Project Title: ________________________________________

g. Period of Performance: ________________________________________

PLEASE MAIL OR FAX THE COMPLETED QUESTIONNAIRE TO:

2d Contracting Squadron

Attn: Ms Lynn Owens 41 Vandenberg Ave Barksdale AFB LA 71110-2079 FAX Number: (318) 456-3294 e-mail: mary.owens.3@us.af.mil

If you have questions regarding this questionnaire, please call Ms. Lynn Owens at (318) 456-0242.

PERFORMANCE INFORMATION: Performance Evaluation Instructions:

1. You are urged to supplement your own knowledge of the contractor’s performance with the judgement of others in your organization. Any marginal ratings should be supplemented with an explanatory narrative in the corresponding comments block for that item. If you wish to elaborate on any of your answers, please provide additional comments at the end of this survey. If more space is needed, continue your comments on a separate sheet of paper and attach it to this questionnaire prior to submitting it to 2 CONS/LGCA.

2. When responding to the descriptive statements, select the letter on the scale that most accurately describing the contractor’s performance or situation. If the contractor has no record of past/present performance relevant to a particular question, select “N for Neutral”.

3. The letters on the scale correspond to the definitions below and are applicable rating levels for the contractor’s performance:

Exceptional (E) During the contract period, contractor performance is meeting (or met) all contract requirements and consistently exceeding (or exceeded) many. Very few, if any, minor problems encountered. Contractor took immediate and effective corrective action.

Very Good (VG ) During the contract period, contracor is meeting (or met) all contract requirements and consistently exceeding (or exceeded) some. Some minor problems encountered.

contractor took timely corrective action.

Satisfactory (S ) During the contract period, contractor performance is meeting (or met) all contract requirements. For any problems encountered, contractor took effective corrective action.

Marginal (M) During the contract period, contractor performance is not meeting (or did not meet) some contract requirements. For problems encountered, corrective action appeared only marginally effective, not effective, or not fully implemented. Customer involvement was required.

Unsatisfactory (U) During the contract period, contractor performance is failing (or fail) to meet most contract requirements. Serious problems encountered Corrective actions were either ineffective or non-existent. Extensive Customer oversight and involvement was required.

Not Appicable (N) Unable to provide a rating. Contract did not include performance for this aspect. Do not know.

PROGRAM MANAGEMENT

1. Effectiveness of overall contract management (including ability to effectively lead, manage, and control the program)

2. Contractor was reasonable, flexible, and cooperative in dealing with your Staff (including the ability to successfully resolve disagreements/disputes)

3. Ability to successfully respond to emergency and/or surge situations

4. Ability to effectively perform sub-contractor management

5. Adherence to contract quality assurance requirements

6. Effectiveness of material management (including Government Furnished Property or Equipment)

7. Effectiveness of acquisition/procurement management

8. Timeliness/completeness/accuracy of submission of required reports and documentation

9. Timeliness/effectiveness of contract problem resolution without extensive customer guidance

10. Ability to work with government personnel during budget cuts and contract descope

11. Ability to meet the schedule or deliver early to the schedule on work activities or projects

PERSONNEL

1. Adequately provide a trained and certified workforce during transition and contract start date

2. Maintained a workforce that possessed requisite technical knowledge, skills, and certifications (as required) throughout the life of the contract

3. Provided a stable work force with minimal personnel turnover that maintained project management continuity

TECHNICAL PERFORMANCE

1. Ability to understand/comply with customer objectives and technical requirements

2. Identify and implement technical improvements or cost savings that benefit the government

Transition

1. Contractor successfully transitioned resources and personnel to assume work under new contract; continuity of services was maintained and seamless

2. Effectiveness transitioning to a new contract without compromising mission support

Cost

1. Accuracy in forecasting contract costs

2. Ability to meet forecasted costs and perform within contract costs

3. Ability to alert Government of unforeseen costs before they occur

4. Sufficiency and timeliness of cost reporting

5. Ability to accurately identify costs for all work activities or projects

6. Able to baseline and document annual cost savings

COMPLIANCE WITH ENVIRONMENTAL LAWS/SAFETY AND SECURITY:

1. Response to notifications of violations while services were being provided

2. Compliance with environmental requirements

3. Compliance with Safety/Security Requirements

Government Contracts Only: Has/was this contract partially or completely terminated for default or convenience or are there any pending terminations?

Yes___ Default___ Convenience___ Pending Terminations___

No ___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc.)

NARRATIVE SUMMARY

a. What were the contractor’s greatest strengths in the performance of the contract?

b. What were the contractor’s greatest weaknesses in the performance of the contract?

c. Has there been any security issues that may/may not have caused a security instance but raised a security concern with this contractor on this contract?

d. Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

e. Please provide any additional comments concerning this contractor’s performance, as desired.

Evaluator’s Signature

Date

Thank you for your prompt response and assistance!