Attachement_10_Past_Performance_Questionaire.pdf

FA4803-13-R-0005

ATTACHMENT 10

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

SUBJECT: Request for Past Performance Evaluation

TO:

You have been identified as a point of contact for a past performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for a Multiple Award Construction Contract (MACC) contract at Shaw AFB, SC.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, you can contact Eric Nagel at eric.nagel@shaw.af.mil, Wesley Batot at wesley.bato@shaw.af.mil or the undersigned at barbara.bonnette@shaw.af.mil .

5/31/2013

X

BARBARA V. BONNETTE

Contracting Officer

1 Attch

Past and Present Performance Questionnaire mailto:eric.nagel@shaw.af.mil mailto:wesley.batot@shaw.af.mil mailto:barbara.bonnette@shaw.af.mil

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: ____________________ Telephone Number: ____________________

Address: __________________________ Fax Number: _________________________

__________________________ Point of Contact: ______________________

Project Title and Brief Description of Work: _____________________________________*

Contract Number Provided by Offeror: ___________________ Dollar Amount: ________*

Contract Period or Dates of Performance Provided by Offeror: ______________________* Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* 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.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ____________________________

Address: _____________________ Telephone Number: ___________________ _____________________________ Fax Number: _____________________ _____________________________ Email Address: _____________________

C. FAX COMPLETED SURVEY FORM TO: Eric Nagel or Wesley Batot at 803-895-5340 or email eric. nagel@shaw.af.mil or wesley.bato@shaw.af.mil

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (A, U, N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF N or U.

A U N

Acceptable Unacceptable Neutral

Based on the offeror’s performance record, the offeror will successfully perform the required effort

Based on the offeror’s performance record, the offeror will be able to successfully perform the required effort.

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

mailto:nagel@shaw.af.mil mailto:wesley.bato@shaw.af.mil

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

Place an “X” in the appropriate column using the definitions matrix above.

The contractor: A U N

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

6. Provided effective quality control and/or inspection procedures to meet contract requirements.

7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

8. Provided timely resolution of contract discrepancies.

9. Identified problems as they occurred.

10. Suggested alternative approaches to problems.

11. Displayed initiative to solve problems.

12. Developed realistic progress schedules.

13. Met established project schedules.

14. Provided timely resolution of warranty defects.

The contractor: A U N

15. Was responsive to contract changes.

16. Provided adequate project supervision.

17. Obtained consent of surety for increases in bonding as work-in-progress increased.

18. Paid subcontractors/suppliers in a timely manner.

19. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

20. Cooperated with Government personnel after award.

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

Remarks:______________________________________________________________________