Past Performance Questionnaire - MacDill Refuse and Recycling Collection-Disposal.pdf

ATTACHMENT 3

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:

Notes:

Project Title and Brief Description of Work:

Did this project include Integrated Solid Waste Management? Y/N Did this project include Universal Waste? Y/N Did this project include International Waste? Y/N Did this project include Recycling Materials Process? Y/N Did this project include a Transition Plan? Y/N

Contract Number Provided by Offeror: Dollar Amount: approx.

Contract Period or Dates of Performance Provided by Offeror: *

* Note: If offeror holds or has held other contracts with your agency/organization in the last 5 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

: Attn: SSgt Bryan Russell, 813 828-1091, or email at bryan.russell.2@us.af.mil

D. PERFORMANCE INFORMATION: Choose the appropriate rating on the scale (ACCEPTABLE and UNACCEPTABLE) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY

RATINGS OF UNACCEPTABLE.

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

ACCEPTABLE UNACCEPTABLE

Based on the offeror’s performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror’s performance record is unknown.

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

The Contractor: ACCEPTABLE UNACCEPTABLE

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

2. Performance of Integrated Solid Waste Management IAW applicable standards.

3. Performance of Recycling Materials Process IAW applicable standards.

4. Performance of Transition Plan.

5. Responsiveness to emergency or special events

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

7. Delegated authority to project managers and supervisors commensurate with

8. Home office participated in solving significant local problems.

Remarks:

9. Followed approved quality control plan.

10. Provided effective quality control and/or inspection procedures to meet

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

12. Provided timely resolution of contract discrepancies.

13. Identified problems as they occurred.

14. Suggested alternative approaches to problems.

15. Displayed initiative to solve problems.

16. Developed realistic progress schedules.

17. Met established project schedules.

18. Was responsive to contract changes.

19. Provided adequate project supervision.

20. Paid subcontractors/suppliers in a timely manner.

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

22. Cooperated with Government personnel after award.

23. How would you rate the contractor's overall performance?