FA4625-14-R-0001_Whiteman_Pavements_Attachment_5_(Past_Performance_Questionaire).pdf

FA4625-14-R-0001 FOR OFFICIAL USE ONLY

Page 1 of 6 FOR OFFICIAL USE ONLY

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR

2.101 AND FAR 3.104

Response to this questionnaire will be included as a basis of evaluation.

SECTION 1: GENERAL INFORMATION

Contractor’s Name: __________________________ Telephone Number: _________________

Address:___________________________________ FAX Number: _____________________

___________________________________ Point of Contact: ___________________

Project Title and Brief Description of Work: _____________________________________________

Contract number: __________________________ Contract type: ________________________

Period of performance: _________________________

Initial contract cost: $____________________________

Current/Final contract cost: $_______________________________

Reasons for differences between initial contract cost and final contract costs:_______________________

SECTION 2: RESPONDENT INFORMATION:

Customer or Agency Name: __________________________________________________________

Name of Respondent: _______________________________ Title: _________________________

Address: ________________________________ Telephone Number: __________________

________________________________ FAX Number: ______________________

_________________________________ Email Address: ______________________

Page 2 of 6 FOR OFFICIAL USE ONLY

SECTION 3: PERFORMANCE INFORMATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question (E, G, S, M, U or N). This scale is defined as follows:

CODE PERFORMANCE RATING

E EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

G GOOD- The contractor’s performance meets contractual requirements and exceeds some

(requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N NEUTRAL – Performance was not observed or not applicable to the current effort being reported against.

Page 3 of 6 FOR OFFICIAL USE ONLY

1. CUSTOMER SATISFACTION: ADDITIONAL COMMENTS

aa. Customer would have no reservation in awarding another contract to the Contractor.

bb. Cooperative, businesslike and concerned with the interest of the customer.

cc. Provided prompt and courteous service when responding to customer complaints.

Overall rating for Customer Satisfaction E G S M U N

2. ORGANIZATION: ADDITIONAL COMMENTS

aa. Contractor demonstrated clear, logical lines of authority from program manager. Demonstrated technical sufficiency including site superintendents and quality control.

bb. Contractor demonstrated the level of decision-making authority was delegated to staff members, project managers had on-site decision making authority.

cc. Contractor provided dedicated on-site staff (if required by contract).

Overall rating for Organization E G S M U N

3. QUALITY: ADDITIONAL COMMENTS

aa. Contractor provided effective quality control and inspection procedures which resulted in a quality finished project.

bb. Contractor developed and submitted realistic progress schedule(s).

cc. Contractor provided well researched and clearly identified submittals that matched contract requirements.

dd. Contractor completed all work with good workmanship and in conformance with the specifications, resulting in minor, if any punch list items.

ee. Contractor complied with all Federal and local laws including OSHA, EPA., etc.

ff. Contractor provided properly designed design drawings/ as-builts and they encompassed all aspects of the Statement of Work.

gg. Contractor’s Quality Control (QC) person had no overlapping of duties or responsibilities that conflicted with performance as QC.

Overall rating for contractor’s Quality E G S M U N

Page 4 of 6 FOR OFFICIAL USE ONLY

4. TIMELINESS: ADDITIONAL COMMENTS

aa. Contractor met established project schedules to complete the project on time, as scheduled.

bb. Contractor performed all work without the issuance of a CURE NOTICE or a SHOW CAUSE LETTER (if a notice was issued, please describe the circumstances on a separate sheet of paper and identify if Liquidated

Damages were assessed).

cc. Contractor provided timely cost/design proposals.

dd. Contractor submitted the progress schedule and interim progress reports as required.

ee. Contractor provided on – time submittals as required.

ff. Contractor provided payrolls for both their firm and their subcontractors employees as required and scheduled.

gg. Contractor provided timely resolution of all punch list items.

Overall rating for contractor Timeliness E G S M U N

5. RESPONSIVENESS: ADDITIONAL COMMENTS

aa. Contractor acted promptly to resolve problems, ensuring compliance with contract requirements and safety regulations.

bb. 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.

cc. Contractor identified problems as they occurred;

corrective action taken when problems occurred, displayed initiative to solve problems; and performed as a “Team Member”.

dd. Contractor realigned performance schedules to meet customer needs when changes occurred.

ee. Contractor responded to warranty issues within the timeframes specified in the contract.

ff. The contractor’s quality control person demonstrated good working relationships with the Government inspectors and the Contracting staff

Overall rating for contractor’s Responsiveness E G S M U N

6. SUBCONTRACTS AND MANAGEMENT: ADDITIONAL COMMENTS

aa. Contractor provided experienced/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

bb. Contractor hired quality subcontractors and effectively managed and coordinated their work.

cc. Contractor hired, maintained, and replaced as necessary, qualified personnel and subcontractors/suppliers.

Page 5 of 6 FOR OFFICIAL USE ONLY

dd. Contractor ensured the site manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule.

ee. Contractor ensured the site manager was consistently present on site when work was performed.

ff. Contractor paid employees/subcontractors/suppliers as required.

Overall rating for contractor’s Subcontracts and

Management

E G S M U N

7. PRICING STRUCTURE: ADDITIONAL COMMENTS

aa. Contractor provided complete, supportable, accurate, and reasonable cost proposals that met the requirements of the project or modification. They were not over-inflated nor were they underestimated.

bb. Contractor demonstrated the ability to control costs and/or design projects or modifications within the magnitude specified.

Overall rating for contractor’s Pricing Structure E G S M U N

8. SAFETY and ENVIRONMENTAL: ADDITIONAL COMMENTS

aa. Contractor demonstrated adequate inspection for safety requirements.

bb. Contractor identified and expediently resolved safety problems.

cc. How well did the contractor comply with environmental requirements.

dd How well did the contractor comply with safety/security requirements.

Overall rating for contractor’s Safety and

Environmental

E G S M U N

Please discuss each and every response for which you indicated M (Marginal) or U (Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

SECTION 5: NARRATIVE SUMMARY

Page 6 of 6 FOR OFFICIAL USE ONLY

From Table 1 above, please indicate an overall performance confidence assessment rating based upon the performance ratings indicated from the questinnaire.___________________________________________

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

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address:

509 CONS/LGCA

ATTN: James McCoy

660 10th Street, Suite 222

Whiteman AFB, MO 65305

Or FAX to: (660) 687-4822

Or email: 509cons.sollgca@us.af.mil

TABLE 1 - PERFORMANCE CONFIDENCE ASSESSMENTS

Rating Description

Substantial Confidence Based on the offeror’s performance record, the Government has a high expectation that the offeror will successfully perform the required effort.

Satisfactory Confidence Based on the offeror’s performance record, the Government has an expectation that the offeror will successfully perform the required effort.

Limited Confidence Based on the offeror’s performance record, the Government has a low expectation that the offeror will successfully perform the required effort.

No Confidence Based on the offeror’s performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.

Unknown Confidence No performance record is identifiable or the offeror’s performance record is so sparse that no confidence assessment rating can be reasonably assigned.

mailto:509cons.sollgca@us.af.mil