Atch_19_Past_Performance_Questionairre.docx

For Official Use Only When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Attachment: 27 Past Performance Questionnaire

The 28th Contracting Squadron of the United States Air Force is in the process of competitively selecting a source for a Multiple Award Construction Contract (MACC) program. MACC is a multiple award, competitive design-build indefinite delivery/indefinite quantity construction acquisition based on a general statement of work further defined with each individual task order.

One of the considerations in proposal evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your written response no later than [insert date].

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to bernard.clemens@us.af.mil and samantha.hough@us.af.mil. Your completed questionnaire will become a part of the official source selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

1 Atch Past Performance Questionnaire

Section 1: Contract Identification

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Project Title:

F. Brief Construction Description:

G. Period of Performance

1. Original Schedule: Beginning Date _________ through ____________

2. Current Schedule: Beginning Date _________ through ____________

3. Delay attributed to (if applicable): ☐ Gov’t ☐ Contractor ☐ Both

H. Contract Dollar Value

1. Original maximum contract dollar value: $

2. Current maximum contract dollar value: $

3. Reasons for difference between original and current contract dollar value (if applicable):

I. Description of work performed:

J. Was this a competitively awarded contract? ☐ Yes ☐ No

K. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor

Section 2: Customer or Agency Identification

A. Customer or agency name:

B. Customer or agency description (if applicable):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone/fax number/e-mail address:

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

E. Other suggested points of contact:

Section 4: Performance Information

In the table below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

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

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains 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 being assessed 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 being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

1. Provide effective quality control and/or inspection procedures and corrected deficiencies in a timely manner to meet contract requirements?

SUPPORTING INFORMATION:

2. Complete all work with good workmanship and in conformance with the specifications?

3. Provide timely design proposals?

4. Provide on-time progress reports, progress schedules, material submittals, and payrolls as required?

SUPPORTING INFORMATION:

5. Meet established project schedules to complete the project on time?

6. Provide timely resolution of warranty defects?

7. Demonstrate the ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period?

8. Hire quality subcontractors and effectively manage and coordinated their work?

How would you rate the contractor's overall performance on this contract?

Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.

EXPLANATION:

☐ Yes ☐ No

Would you award another contract to this contractor? If not, explain.

EXPLANATION:

☐ Yes

Were at least five (5) disciplines used to perform the work on this effort?

Please check which disciplines were utilized:

☐ A&E Design ☐ Carpentry ☐ Interior finishes ☐ Electrical ☐ Plumbing ☐ HVAC

☐ Sheet metal ☐ Fire suppression ☐ Roofing ☐ Demolition ☐ Masonry

☐ Excavation ☐ Structural ☐ Painting ☐ Fire Alarm

☐ Yes

Additional remarks:

[click and pick the date]

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

bernard.clemens@us.af.mil and samantha.hough.2@us.af.mil For Official Use Only Page 5 of 5