Attch 6 Past Perf Questionaire_ Atch 6.doc

Attachment 6

FA4626-09-R-0017

FOR OFFICIAL USE ONLY

J-500 PRESENT/PAST PERFORMANCE EVALUATION CONTRACTOR PERFORMANCE QUESTIONNAIRE

SECTION 1: TO BE COMPLETED BY THE OFFEROR AND PROVIDED TO THE CUSTOMER REFERENCED Name of Firm being evaluated: ___________________________________ Project Title and Location: _______________________________________ Project Description: _____________________________________________ Project Dollar Value: ____________________________________________ Year Completed: _______________________________________________ Project Manager: _______________________________________________ SECTION 2: TO BE COMPLETED BY THE CUSTOMER REFERENCED AND MAILED, HAND-DELIVERED, EMAILED OR FAXED DIRECTLY TO:

341 CONS/LGCA

FAX: (406) 731-4005/3748

ATTN: SSgt. Oleg Perchine

EMAIL: oleg.perchine@malmstrom.af.mil 7015 Goddard Drive, Bldg 145 DUTY PHONE 406-731-4004 Malmstrom AFB, MT 59402-6863 OVERVIEW: The firm shown above is submitting a proposal on a Malmstrom AFB construction/service project and provided your name as a customer reference. Part of our evaluation process requires information on the firm’s past performance. Your participation is important to us and responses are required by 20 May 2009 but no later than the proposal closing date of 29 May 2009, 2:00PM local time. Your assistance is greatly appreciated.

SECTION 3: 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 or customer’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VG

VERY GOOD- The contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s or customer’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.

Quality Control Quality of workmanship

Adequacy, implementation and documentation of Quality Control Plan

Storage and Adequacy of Materials – kept secure, neat and orderly, protected from the elements

Adequacy of Submittals – re-submittals not excessive, submittal data is clear, concise and thorough

Adequacy of QC Testing – provides all tests as required

Adequacy of As-Builts- contractor maintains accurate up-to-date red line drawings on site per specifications

Use of Specified Materials – contractor used specified or equal material or products

Identification/correction of deficient work in a timely manner

Effective Management Cooperation and Responsiveness – responds to all communications in timely manner, solicits feedback and suggests superior alternatives.

Management of Resources/Personnel – maintains good construction pace and work environment

Coordination and control of subcontractors – insures adherence to work schedule, Adequacy of site clean up- all work and storage areas are cleaned and secured at end of each day

Effectiveness of jobsite supervision – site is safe and secure, clear line of supervision.

Compliance with laws and regulations

Professional conduct

Review/resolution of subcontractors issues

Implementation of Subcontracting Plan (applicable to large businesses)

Timely Performance Adequacy of initial progress schedule and adherence to approved schedule. Submission of revised schedules if needed

Resolution of Delays

Submission of required documentation

Completion of punch-list items

Warranty response

Compliance with Labor Standards Payrolls properly completed and submitted

Compliance with Davis-Bacon Act and EEO requirements

Compliance with Safety Standards Adequacy and Implementation of Safety Plan

Correction of noted deficiencies

BASED UPON OVERALL PERFORMANCE PLEASE PROVIDE OVERALL RATING OF CONTRACTOR BASED UPON RATINGS DEFINED ABOVE

PRINTED NAME OF EVALUATOR: _____________________________

SIGNATURE:

DATE:

COMPANY NAME: ____________________________

PHONE NUMBER: ____________________________

EMAIL ADDRESS: ____________________________