2012 MATOC Atch 5 Past Perf Questionnaire rev 3 May 12.pdf

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104

FA4620-12-R-B002

Attachment 5

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104 1

Past Performance Evaluation Questionnaire Solicitation FA4620-12-R-B002, Fairchild AFB WA-MATOC

SECTION 1: CONTRACTOR INFORMATION (to be completed by the contractor requesting evaluation prior to mailing)

A. Contractor’s name and address:

B. Point of Contact:

C. Phone Number (with area code):

D. Contract Number:

E. Project Title or Description of Work performed under this project:

F. Contract Type: Firm Fixed Price Indefinite Deliver/Indefinite Quantity Task Order Cost Reimbursement

G. Project Award Date: Schedule Completion Date:

Current/Final Completion Date:

H. Project Award Amount: Current/Final Project Amount:

I. Contractor being evaluated performed as the Prime Contractor Subcontractor

Supplier on the contract/order

J. Authorization is hereby granted to provide the information requested in SECTION B of this Questionnaire.

(Signature)

(Name and Title of Authorizing Official) (Date)

SECTION 2: RESPONDENT INFORMATION (to be completed by respondent)

EVALUATED BY:

(Signature) (Date) Address:

(Typed or Printed Name)

(Title)

Phone Number:

Number of years evaluator worked on subject contract:

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104 2

SECTION 3: PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 6 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

1 2 3 4 5

NO CONFIDENCE LIMITED CONFIDENCE UNKNOWN CONFIDENCE SATISFACTORY

CONFIDENCE

SUBSTANTIAL

CONFIDENCE

Based on the contractor’s performance record, the contractor did not successfully perform the required effort.

Based on the contractor’s performance record, the contractor was somewhat successful in performing the required effort.

No or very limited performance information is available therefore no meaningful rating can be reasonably assigned.

Based on the contractor’s performance record the contractor successfully performed the required effort.

Based on the contractor’s performance record the contractor was highly successful in performing the required effort.

Evaluation Areas

1. CUSTOMER SATISFACTION:

Customer would have no reservations in awarding another contract to the

Contractor.

1 2 3 4 5 N/A

2. QUALITY:

a Contractor provided effective quality control and/or inspection procedures to meet contract requirements 1 2 3 4 5 N/A b Contractor provided well researched and clearly identified submittals that matched contract requirements

1 2 3 4 5 N/A c Contractor completed all work with good workmanship and in conformance with the specifications

1 2 3 4 5 N/A d Contractor corrected deficiencies in a timely manner and pursuant to their quality control plan

1 2 3 4 5 N/A

3. TIMELINESS:

a Contractor met established project schedules to complete the project on time 1 2 3 4 5 N/A b Contractor provided timely cost/design proposals 1 2 3 4 5 N/A c Contractor submitted the progress schedule and progress reports as required 1 2 3 4 5 N/A d Contractor provided on-time submittals as required 1 2 3 4 5 N/A e Contractor provided payrolls for both their employees and their subcontractors employees as required 1 2 3 4 5 N/A f Contractor provided timely resolution of all punch list items 1 2 3 4 5 N/A

4. RESPONSIVENESS:

a Contractor acted promptly to resolve problems, ensuring compliance with contract requirements and safety regulations 1 2 3 4 5 N/A b Contractor was reasonable and cooperated to resolve problems, attended meetings as needed, and maintained communication with the government to keep the project on schedule or minimize the delay

1 2 3 4 5 N/A c Contractor identified problems as the occurred; suggested approaches to the problems; displayed initiative to solve problems; and performed as a Team Member

1 2 3 4 5 N/A d Contractor responded to warranty issues within the time frames specified in the contract

1 2 3 4 5 N/A

5. SUBCONTRACTS AND MANAGEMENT:

a Contractor provided experienced/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements 1 2 3 4 5 N/A b Contractor hired quality subcontractors and effectively managed and coordinated their work

1 2 3 4 5 N/A c Contractor hired, maintained, and replaced as necessary, qualified personnel and subcontractors/suppliers

1 2 3 4 5 N/A d Contractor ensured the project manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule

1 2 3 4 5 N/A e Contractor ensured site superintendent and quality control representative were consistently present on site when work was performed

1 2 3 4 5 N/A f Contractor paid employees/subcontractors/suppliers as required 1 2 3 4 5 N/A

SOURCE SELECTION INFORMATION – SEE FAR 2.101 AND 3.104 3

6. DESIGN:

a Contractor provided complete, supportable, technically sound designs for the project 1 2 3 4 5 N/A b Contractor demonstrated the ability to incorporate user’s requirements into the design

1 2 3 4 5 N/A c Contractor completed designs that were constructed in the same manner as they were designed

1 2 3 4 5 N/A

7. CHANGE/COST CONTROL:

a Contractor responsive to contract changes and provided accurate, reasonable and supportable cost proposals 1 2 3 4 5 N/A b Contractor demonstrated the ability to control costs and/or design projects or modifications within the magnitude specified

1 2 3 4 5 N/A c Contractor validated subcontractor cost proposals prior to submission to the Government

1 2 3 4 5 N/A

REMARKS:

SECTION 4: NARRATIVE SUMMARY

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

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

3. Please provide any additional comment concerning the contractor’s performance, as desired.

4. GOVERNMENT CONTRACTS ONLY: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

No Yes Default Convenience Pending Terminations

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

5. GOVERNMENT CONTRACTS ONLY: Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “Remarks”. No Yes

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing address: Richard Hedrick 92d Contracting Squadron 110 West Ent Street Fairchild AFB WA 99011-8568

Or Email: richard.hedrick.2@us.af.mil

Or FAX to: Richard Hedrick at 509-247-8685