PAST PERFORMANCE QUESTIONNAIRE.doc

DOC document 43 KB Posted May 13, 2011

Attached to: Airfield and Base Paving IDIQ on Luke Air Force Base and Gila Bend Auxiliary Field
Solicitation number: FA4887-11-R-0003
Issued by: Department of the Air Force Air Education and Training Command

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Past Performance Questionnaire

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PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTIN SENSITIVE

IAW FAR 2.101 AND 3.104

RFP: FA4887-11-R-0003

CONTRACTOR: __________________________

I. Background

The purpose of this questionnaire is to obtain past performane information relative to contracts that have previously been completed within the past five years or are currently being performed by the contractor identified above. This company is a potential source for performing a Firm Fixed Priced contract.

II. Instructions

Please complete the questionnaire based on the following guidance:

A. Handwritten responses are sufficient.

B. Indicate, based on the description below, the contractor’s performance on the identified program in the assessment area. Assessments should reflect only contractor liable performance. The following is a definition of the scoring levels:

Rating

Definition

High Confidence

Based on the offeror’s performance record, the Government has high confidence the offeror will successfully perform the required effort.

Significant Confidence

Based on the offeror’s performance record, the Government has significant confidence the offeror will successfully perform the required effort.

Satisfactory Confidence

Based on the offeror’s performance record, the Government has confidence the offeror will successfully perform the required effort. Normal contractor emphasis should preclude any problems.

Unknown Confidence

No performance record is identifiable (see FAR15.305(a)(2)(iii) and (iv)).

Little Confidence

Based on the offeror's performance record, substantial doubt exists that the offeror will successfully perform the required effort.

No Confidence

Based on the offeror's performance record, extreme doubt exists that the offeror will successfully perform the required effort.

Circle the word corresponding to your rating

C. Please provide comments for all questions in which a “No Confidence”, “Little Confidence”, or “Satisfactory Confidence” rating is given and as appropriate for all other answers. Space for your comments is provided in each area. If more space is needed, attach additional sheets to the end of the questionnaire and reference the respective question.

D. You are urged to supplement your own knowledge of the offeror’s performance with the judgement of others in your organization. In addition to completing the attached questionnaire for the program, we solicit your comments on other similar programs for which your office has contracts with this offeror.

E. PLEASE FAX YOUR COMPLETE QUESTIONNAIRE WITHIN 7 DAYS AFTER RECEIPT, BUT NO LATER THAN 10:00am, TO:

56 CONS/LGCB

ATTN: Lissette Fernandez Contracting Officer

Commercial FAX: 623-856-3438

DSN: 896-3438

Commercial Voice: 623-856-2791

DSN: 896-2791

YOUR ASSISTANCE IN EVALUATING THE CONTRACTOR’S PAST PERFORMANCE IS APPRECIATED. OUR GOAL IS TO SELECT THE BEST VALUE TO THE GOVERNMENT. YOUR PAST PERFORMANCE EVALUATION IS A CONSIDERATION IN DETERMINING THE BEST VALUE.

III. Program Identification:

Evaluator please complete.

A. Contractor: _______________________________________________

B. Contract Number: __________________________________________

C. Estimated contract dollar amount: _____________________________

D. Period of Performance: _____________________________________

E. Describe product acquired: ___________________________________

F. Contract Type: ____________________________________________

IV. Past Performance Evaluation:

1. How would you rate the contractor’s overall performance on the project?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence No Confidence Unknown Confidence Comments: ___________________________________________________________________

2. How would you rate the contractor’s responsiveness and flexibility in working around the end user’s flying schedule?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

Comments:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. How would you rate the contractor’s experience with working on a military installation (i.e, contractor was cognizant of, and had no difficulty in complying, with stringent military standards/regulations)?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

THE CONTRACTOR:

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

High Confidence Significant Confidence Satisfactory Confidence Little Confidence No Confidence Unknown Confidence

Comments: ___________________________________________________________________

5. Effectively managed subcontractors (if used)?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

Comments: ___________________________________________________________________

6. Corrected deficiencies in a timely manner and pursuant to their quality control procedures?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

7. Displayed initiative to solve problems?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

8. Developed realistic progress schedules?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

9. Met established project schedules?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

10. Cooperated with Government personnel after award?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

11. Was responsive to contract changes?

High Confidence Significant Confidence Satisfactory Confidence Little Confidence

No Confidence Unknown Confidence

Put an X next to the most applicable answer:

Knowing what I know about this contractor.

____I would not enter into another contract with this contractor

____I might enter into another contract with this contractor

____I would enter into another contract with this contractor

V. Respondent Information:

The following information will assist in the analysis of the data and will be kept confidential.

A. Name of Evaluator:______________________________________

B. Office Symbol/Location:__________________________________

C. Phone (Commercial/DSN):________________________________

D. Position of Title/Grade:___________________________________

E. Length of Time on Program/Contract:________________________

F. Date Questionnaire Completed:_____________________________

File details come from the government source that posted it. Updated Nov 14, 2017.