Attachment 4 Past Performance Questionaire.docx
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- Attached to
- MacDill AFB Habitat Restoration Services IDIQ Federal contract opportunity
- Solicitation number
- FA4814-11-R-0019
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Attachment 4 Past Performance Questionaire
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ATTACHMENT 4
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: ____________________________________*
| Did this project include Applying Herbicides? | YES / NO | ||||
| Did this project include Hand Cutting/Chipping Trees? | YES / NO | ||||
| Did this project include Equipment Mobilization for Mech Clearing? | YES / NO | ||||
| Did this project include Mechanical Clearing? | YES / NO | ||||
| Did this project include Aquatic Invasive Species Control? | YES / NO | ||||
| Did this project include Prescribed Burning? | YES / NO | ||||
| Did this project include Creating Fire Breaks for Burning? | YES / NO |
Did this project include Installing Sod and Planting Vegetation? YES / NO Did this project include Wildflower Demonstration Maintenance? YES / NO
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: | _____________________ | |
| Fax Number: ______________________ | Email Address: _____________________ |
C. EMAIL COMPLETED SURVEY FORM TO: michael.winstead@us.af.mil
CONTRACTOR’S NAME: __________________ CONTRACT #___________________
D. PERFORMANCE INFORMATION: Choose the appropriate rating on the scale (SUBCON, SATCON, LIMCON, NOCON, and UNCON) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF NOCON or UNCON.
| SUBCON |
| SATCON |
| LIMCON |
| NOCON |
| UNCON |
| SUBSTANTIAL CONFIDENCE |
| SATISFACTORY CONFIDENCE |
| LIMITED CONFIDENCE |
| NO |
CONFIDENCE
UNKNOWN CONFIDENCE
| Based on the offeror’s performance record, the respondent has a high expectation that the offeror will successfully perform the required effort. |
| Based on the offeror’s performance record, the respondent has an expectation that the offeror will successfully perform the required effort. |
| Based on the offeror’s performance record, the respondent has a low expectation that the offeror will successfully perform the required effort. |
| Based on the offeror’s performance record, the respondent has no expectation that the offeror will be able to successfully perform the required effort. |
| No performance record is identifiable or the offeror’s performance record is so sparse that no confidence assessment rating can be reasonably assigned. |
Place an “X” in the appropriate column using the definitions matrix above.
The contractor:
| SUBCON |
| SATCON |
| LIMCON |
| NOCON |
| UNCON |
| 1. |
| Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements. |
| 2. |
| Performance of any or all of the following as a whole: Applying Herbicides, Hand Cutting/Chipping Trees, Equipment Mobilization for Mech Clearing, Mechanical Clearing, Aquatic Invasive Species Control, Prescribed Burning, Creating Fire Breaks for Burning, Installing Sod and Planting Vegetation, Wildflower Demonstration Maintenance. |
| 3. |
| Responsiveness to emergency or special events. |
| 4. |
| Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period. |
| 5. |
| Delegated authority to project managers and supervisors commensurate with contract requirements. |
6.
Home office participated in solving significant local problems.
| 7. |
| Followed approved quality control plan. |
| 8. |
| Provided effective quality control and/or inspection procedures to meet contract requirements. |
| 9. |
| Corrected deficiencies in timely manner and pursuant to their quality control procedures. |
| 10. |
| Provided timely resolution of contract discrepancies. |
| 11. |
| Identified problems as they occurred. |
| 12. |
| Suggested alternative approaches to problems. |
| 13. |
| Displayed initiative to solve problems. |
| 14. |
| Developed realistic progress schedules. |
| 15. |
| Met established project schedules. |
| 16. |
| Was responsive to contract changes. |
| 17. |
| Provided adequate project supervision. |
| 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 organization personnel after award. |
| 21. |
| How would you rate the contractor's overall performance? |
22.
Was the contractor ever issued a warning of termination or penalty under the referenced contract? YES/NO If yes, explain outcome in “remarks”.
| 23. |
| Would you award another contract to this contractor? YES/NO If not, explain in “remarks”. |
Remarks:___________________________________________________________________________________________________________________________________________________________________________________________________________________
CONTRACTOR’S NAME: __________________ CONTRACT #___________________
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