Past Perform Questionnaire.doc

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Attached to
Hazardous Waste Management Support Federal contract opportunity
Solicitation number
FA4621-08-R-0001
Issued by
Department of the Air Force Air Mobility Command

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FA4621-08-R0001 Attachment 3 HWMS Past Performance Questionnaire

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Other files for this federal contract opportunity

Other files attached to Hazardous Waste Management Support, newest first.
File Type Posted
HWMS Amend 0001 w atchs.pdf PDF
HWMS Preproposal Conf Minutes w atchs.pdf PDF
1HW PWS 15 May Final for posting without FOUO Docs.pdf PDF
HWMS Solicitation.pdf PDF
Pre-Proposal Conference Notice.pdf PDF
WD 2005-2215 Rev 7.pdf PDF
WAWF Routing Sht.pdf PDF

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Attachment No. 3

PAST PERFORMANCE QUESTIONNAIRE

HAZARDOUS WASTE MANAGEMENT SUPPORT SERVICES

FA4621-08-R-0001

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 or Brief Description of Work:

Contract Number: ________________________ Dollar Amount: $ per

Contract Period or Dates of Performance Provided by Offeror:

*Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

Contractor performed as the ( Prime Contractor ( Sub-Contractor ( Key Personnel.

B.

RESPONDENT INFORMATION:

Name of Respondent: __________________________________________________________________

Title: _______________________________________________________________________________

Address: _____________________________________________________________________________

Telephone Number: ____________________________Fax Number: ____________________________

Email Address:

C.

FAX COMPLETED SURVEY FORM TO THE GOVERNMENT AT: 316-759-4538

If there are any questions or comments, please contact John Person 316-759-4519, email: john.person-02@mcconnell.af.mil.

D.

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 2 OR 3.

1
2
3
4
5

UNKNOWN CONFIDENCE

(UC)

NO CONFIDENCE (NC)
LIMITED CONFIDENCE

(LC)

SATISFACTORY

CONFIDENCE

(SAC)

SUBSTANTIAL CONFIDENCE

(SC)

. No record of past performance or the record is inconclusive
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..
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.

CONTRACTOR’S NAME: ________________________ CONTRACT N0. _____________________

The contractor:
UC
NC
LC
SAC
SC
1.
Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.
1
2
3
4
5
2.
Home office participated in solving significant local problems.
1
2
3
4
5
3.
Provided effective quality control and/or inspection procedures to meet contract requirements.
1
2
3
4
5
4.
Complied with all federal, state and local laws and regulations to include appropriate licensing.
1
2
3
4
5
5.
Complied with all USAF regulations.
1
2
3
4
5
6.
Corrected deficiencies in timely manner and pursuant to their quality control procedures.
1
2
3
4
5
7.
Identified problems as they occurred.
1
2
3
4
5
8.
Suggested alternative approaches to problems.
1
2
3
4
5
9.
Displayed initiative to solve problems.
1
2
3
4
5
10.
Met established project schedules.
1
2
3
4
5
11.
Was responsive to contract changes.
1
2
3
4
5
12.
Provided adequate project supervision.
1
2
3
4
5
13.
Cooperated with Government personnel after award.
1
2
3
4
5
14.
How would you rate the contractor's overall performance?
1
2
3
4
5
15.
Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”
Yes
No
16.
Would you award another contract to this contractor? If not, explain in “remarks.”
Yes
No
17.
Is this contract rated in CPARS?
Yes
No

Remarks:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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