17-Q-0005_WAFB_Steam_Heat_Plant_Atch_5,_Past_Performance_Questionnaire.pdf

FA4625-17-Q-0005, Attachment 6

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

Date:

WHEN FILLED IN THIS

DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: ________________________________________________________________

B. Cage Code of contractor contract was awarded to: _________________________________

C. Contract number: _______________________________________

D. Contract type: ______________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance:

G. Initial contract cost: $____________________________

H. Current/final contract cost: $_______________________________

I. Reasons for differences between initial contract cost and final contract costs:

J. Description of service provided:

Article I. SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other

Commands:_________________________________________________________________

Article II. SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name:

B. Evaluator's title:

C. Evaluator's phone/fax number:

Number of years evaluator worked on subject contract: _____________________

SECTION 4: EVALUATION

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. This scale is defined as follows:

CODE PERFORMANCE LEVEL

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.

V VERY 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 NOT APPLICABLE - Unable to provide a score.

a.

1. CUSTOMER SATISFACTION ADDITIONAL COMMENTS

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

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

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

Overall rating for Customer Satisfaction E V S M U N

2. ORGANIZATION ADDITIONAL COMMENTS

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

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

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

Overall rating for Organization E V S M U N

3. QUALITY: ADDITIONAL COMMENTS

a. Contractor demonstrated effective logistic planning associated with work.

b. Contractor demonstrated effective management and supervision associated with the work.

c. Contractor maintained insurance coverage with an “A” rating for the warehouse, workmen compensation, liability and automobile.

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

4. TIMELINESS: ADDITIONAL COMMENTS

a. Contractor met established service schedules.

b. 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).

c. Contractor provided on – time invoices as required.

5. RESPONSIVENESS: ADDITIONAL COMMENTS

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

b. Contractor was reasonable and cooperated to resolve problems, attended meetings as needed, and maintained communication with the government.

c. Contractor identified problems as they occurred;

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

d. The contractor’s quality control person demonstrated good working relationships with the Government

Inspectors and the Contracting Staff

Overall rating for contractors Responsiveness E V S M U N

6. SUBCONTRACTS AND MANAGEMENT: ADDITIONAL COMMENTS

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

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

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

d. Contractor ensured the site manager had sufficient authority to make decisions and take actions during performance.

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

Overall rating for Contractors Subcontracts and

Management.

E V S M U N

7. PRICING STRUCTURE:

ADDITIONAL COMMENTS

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

Overall rating for contractors Pricing structure E V S M U N

8.

SAFETY and ENVIRONMENTAL:

b) ADDITIONAL

COMMENTS

a. Contractor demonstrated adequate inspection for safety requirements.

b. Contractor identified and expediently resolved safety problems.

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

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

Overall rating for contractors Safety and

Environmental.

E V S M U N

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

3. Government Contracts Only: Has/was this contract been 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).

SECTION 5: NARRATIVE SUMMARY

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

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

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address:

509 CONS/LGCA

ATTN: SSgt Jerald Belford

660 Tenth St., Ste 222

Whiteman AFB, MO 65305

Or FAX to: (660) 687-4822

Or email: 509CONSLGCB@us.af.mil mailto:509CONSLGCB@us.af.mil