Atch4_PP_Survey.pdf

Attachment 4 to Solicitation No. FA5209-14-R-0023

FOR OFFICIAL USE ONLY WHEN FILLED OUT

PAST/PRESENT PERFORMANCE SURVEY

SOLICITATION NO. FA5209-14-R-0023

INFORMATION TECHONOLOGY (IT) PROJECT MANAGEMENT AND IT

SYSTEMS ANALYSIS SUPPORT FOR THE 374TH COMMUNICATIONS

SQUADRON’S PLANS & RESOURCES FLIGHT AT YOKOTA AB JAPAN

DECEMBER 2014

FOR OFFICIAL USE ONLY WHEN FILLED OUT

PAST PERFORMANCE SURVEY

FOR

SOLICITATION NO. FA5209-14-R-0023

The U.S. Government is placing increased emphasis in its acquisitions on “past performance” as a source selection evaluation factor. You have been provided as a reference in response to the subject solicitation for IT Project Management & IT Systems Analysis Support for the 374th Communications Squadron’s Plans & Resources Flight at Yokota AB Japan in order for the Government to evaluate the past performance of the firm providing you as a reference. Please provide concise comments regarding your assessment of the contractor’s performance regarding this project. In accordance with FAR 15.306(e)(4), the name of individuals providing reference information about an offeror’s past performance shall not be disclosed.

Upon completion of this survey, please fax it to 374th Contracting Squadron/LGCZ at 81-42-551-0973 (within Japan) or send it by email to the address shown below no later than 23 Jan 2015, 1400 hours (Japan time).

374th Contracting Squadron/LGCZ Attn: Ms. Sawako Arioka Unit 5228

APO AP 96328-5228

Email: sawako.arioka.jp@us.af.mil

The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable.

1. RESPONDENT INFORMATION:

Please provide the information requested below to assist the 374th Contracting Squadron. You may be contacted for additional information pertaining to past/present performance of the contractor identified below. This information will be kept confidential.

A. Company Name:

B. Name:

C. Position and Title:

D. Telephone Number:

Fax Number:

E. Address:

F. Relationship and Time Involved with Contractor:

2. CONTRACT INFORMATION. Please provide the following information about the contractor provided or are currently providing services for your company/agency:

A. Contractor:

B. Contractor’s address:

C. Point of Contact:

D. Contract Number, if applicable:

E. Period of Performance (the entire period) (Ex. From MMM/YY to MMM/YY; XX months/years:

F. Contract Type:

Fixed Price:

Cost Reimbursement:

Other:

G. Contract Amount (Basic year and all option years):

H. Prime contractor:

YES

NO

Description of Work Performed:

I. What services were/currently provided to your company? Please describe it concretely. Also, what is the level of complexity?

3. PERFORMANCE INFORMATION: The definitions for the adjectival rating categories are provided below:

E: Exceptional – Performance met all contract requirements and exceeded many of the entire contractual requirements. Problems, if any, were negligible, and were resolved in a timely and highly effective manner.

VG: Very Good – Performance met all contract requirements and exceeded some of the entire contractual requirements. There were a few minor problems, which the contractor resolved in a timely, effective manner.

S: Satisfactory – Performance met contract requirements. There were some minor problems, and corrective actions taken by the contractor were satisfactory.

M: Marginal – Performance did not meet some of the contractual requirements. There were problems, some of a serious nature, for which corrective action was only.

U: Unsatisfactory – Performance did not meet contractual requirements. There were serious problems, and the contractor’s corrective actions were ineffective.

N/A: Not Applicable – There is no applicable portion.

When responding to the questions listed, please check √ the rating box for the scale of (U) to (E) that most accurately describes the contractor’s performance or situation. For any marginal (M) or unsatisfactory (U) rating, please provide explanatory narratives in the comments block. If a question is not applicable, circle N/A. If more

FOR OFFICIAL USE ONLY WHEN FILLED OUT

space is needed, use the back of the questionnaire or attach additional pages. Handwritten responses to this questionnaire are acceptable. However, if responses are handwritten, please print legibly.

<Quality of Work>

1. The Contractor’s ability to effectively control the quality of services provided.

E VG S M U N/A

Comments:

2. The Contractor’s ability to meet appropriate staffing levels with sufficient number of qualified personnel with work ethic and customer service skills in order to provide required services.

3. The Contractor substantiated credible pricing data for change orders/modification.

4. Was the Contract partially or completely terminated for default or convenience?

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules). E VG S M U N/A

FOR OFFICIAL USE ONLY WHEN FILLED OUT

5. The Contractor identified problems as they occurred and displayed initiative to solve the problem. E VG S M U N/A

6. Was there a requirement for providing the IT project management? If the answer is YES, was the contractor successful in meeting this requirement?

7. Was there a requirement for providing the IT systems analysis support? If the answer is YES, was the contractor successful in meeting this requirement?

8. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES [ ] NO [ ]

Remarks:

9. The contractor provided adequate project supervision.

10. Have you filed claims involving loss or damage?

YES NO

E VG S M U

N/A

a. If YES, rate the Contractor demonstrated a cooperative behavior.

b. If YES, number of records of claims? ( )

<Timely Performance/Schedule>

14. The Contractor developed realistic progress schedules and met established project schedules. E VG S M U N/A

15. Contractor’s ability to meet specific response times and required time frames for providing the services.

16. Contractor’s timeliness in responding to emergency service requirements.

Contractor’s flexibility in satisfying the requirements of its customers.

17. Contractor’s responsiveness/timeliness for providing monthly reports/ documents/ submittals required by the contract. E VG S M U N/A

<Effectiveness of Management for Resolution of Issues/Problems/Customer Complaints>

18. Were key personnel knowledgeable about contractual requirements?

FOR OFFICIAL USE ONLY WHEN FILLED OUT

19. Have you had any manning/staffing problems, such as, under manning, no-qualified personnel? And after recognizing the problems, the problems have been solved and contractor demonstrated a cooperative behavior?

YES NO

If YES, rate if the Contractor demonstrated a cooperative behavior.

If NO, check N/A

20. Provided timely resolution of contract discrepancies/problems. Contractor’s ability to correct problems and prevent or mitigate potential problems in a timely manner.

21. If the company used subcontractors, how well did the company manage subcontractors?

22. Does the company resolve issues, problems, customer complaints in a timely manner?

<Compliance with the Applicable Rules, Regs, Laws, including Safety Standards>

23. Contractor’s safety standards to meet the applicable Government policies, regulations, and contract requirements.

24. Based on this contractor’s overall performance, would you hire this contractor again?

OVERALL RATING (総合評価)

25. BASED ON THE ABOVE, WHAT IS YOUR OVERALL ASSESSMENT OF

THE PRESENT/PAST PERFORMANCE FOR THIS CONTRACTOR? AND

WHY?

The undersigned hereby confirms that the information provided in this document is correct as written. Should any corrections be required, the undersigned shall contact the Contract Specialist at 042-553-8549 (within Japan) / 011-81-31175- 52256 (from overseas) or email: sawako.arioka.jp@us.af.mil by 30 Jan 2015, 1400 hours (Japan time). This confirmation shall allow the 374th Contracting Squadron to use the information contained herein as source selection information. Thank you very much.

Signature Date

Thank you for your cooperation.