Past Performance Questionnaire.pdf

A. GENERAL INFORMATION: Please correct any information below if inaccurate:

Contractor’s Name:

Point of Contact:

Address:

Telephone Number:

* Project Title and Brief Description of Work:

* Contract Number Provided by Offeror:

* Contract Period or Dates of Performance Provided by Offeror:

Contractor performed as the Prime Contractor, Sub-Contractor, or Key Personnel.

Name of Respondent: Title:

Address:

Telephone Number:

Email Address:

C. COMPLETED SURVEY FORM AND FORWARD TO 673d CONS/LGCB VIA:

or Mail: 673rd CONS/LGCB ATTN: Anthony Vaughn

10480 22nd Street, Suite 364 Joint Base Elmendorf-Richardson, AK 99506

* 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.

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

Email: anthony.vaughn@elmendorf.af.mil or Fax: (907) 552-0552

Fax Number:

Dollar Amount:

Fax Number:

B. RESPONDENT INFORMATION:

FA5000-11-R-0029

Attachment 9

Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

E G S M U N

Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element 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.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

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

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

CONTRACTOR’S NAME:

CONTRACT NUMBER:

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

E G S M U N

1.

2.

3.

4.

5.

6.

7.

8.

YES NO

YES NO

YES NO

12. YES NO

Was proactive at anticipating potential problems, communicating them to the customer, resolving them and/or suggesting a resolution.

Responded to emergency, surge situations and/or short notice unscheduled requirements?

If the contractor was required to purchase or lease any vehicles were the vehicles efficiently managed and maintained and were there ever any performance delays due to a lack of a vehicle? Please explain in “remarks”

Was the contractor ever issued a cure or show cause notice or Contract Deficiency Report (CDR) under the referenced contract? If yes, explain outcome in “remarks.”

Did the contractor establish and maintain good-house keeping procedures for equipment used before, during, and after aircraft wash services

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

9.

10.

11.

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

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

Provided effective quality control and/or inspection procedures to meet contract requirements as outlined in their quality control plan.

Identified risks/problems as they occurred.

Maintained an effective training program to ensure a competent and efficient workforce composition to meet all contract requirements.

Please rate how well the contractor:

Did the contractor have to provide a highly visible Wash Service, requiring the utmost attention to detail where re-performance was not an option, such as Services for distinguished visitors? If yes, please address contractor performance in “remarks”.

CONTRACTOR’S NAME:

CONTRACT NUMBER:

RESPONDENT SIGNATURE:

DATE:

Remarks: