Past Perf Questionnaire.pdf

PAST PERFORMANCE INFORMATION QUESTIONNAIRE

UPON INSERTION OF INFORMATION THIS DOCUMENT BECOMES

SOURCE SELECTION SENSITIVE IN ACCORDANCE WITH FAR PART 3.104

Solicitation: FA5682-12-R-0001

REFUSE COLLECTION AND DISPOSAL SERVICES, AVIANO AB,

ITALY

Contractor's Name: ___________________________________________

Contract Number: ____________________________________________

Performance Period: ___________________________________________

Type of Contract: ______________________________________________

Contract Value: _______________________________________________

Contractor Client Name: _______________________________________

Client POC: ________________________________________

1. In this section of the questionnaire, you are asked to rate the contractor. Please indicate the rating that best applies. You may provide comments at the end of this document if you desire to elaborate on any of your answers. Please use additional sheets of paper if more space is needed.

2. If replying by mail or fax please address this document as follows:

st

CONTRACTING SQUADRON/LGCC

Solicitation: FA5682-12-R-0001

REFUSE COLLECTION AND DISPOSAL SERVICES

Via Pordenone, Area “E” Edif. 600

Base Aerea di Aviano

33081 AVIANO (PN), ITALY

Our Commercial numbers are:

0434 30 4313/7132 - Fax 0434 30-8557 (within Italy)

Fax: 011 39 0434 30 8557 (International)

PLEASE PROVIDE THIS INFORMATION BY:

16:00hrs Central European Time (CET) - 04 May, 2012.

Rating (ABBREVIATION) Description

SUBSTANTIAL CONFIDENCE

(HC)

Based on the offeror‟s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort.

SATISFACTORYCONFIDENCE

(SC)

Based on the offeror‟s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.

LIMITED CONFIDENCE (LC)

Based on the offeror‟s recent/relevant performance record, the Government has low expectation that the offeror will successfully perform the required effort.

NO CONFIDENCE (NC) Based on the offeror‟s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.

UNKNOWN CONFIDENCE

(NEUTRAL) (UC)

No recent/relevant performance record is available or the offeror „s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

A. SERVICE QUALITY

RATING: HC SC LC NC UC

1. Contractor‟s ability to meet minimum quality standards specified for performance.

2. Contractor‟s ability to effectively control the quality of services provided.

3. Contractor‟s compliance with contractual terms and conditions.

YES NO

4. Was re-performance of non conforming services services frequent.

5. Has a Contract Discrepancy Report ever been issued?

B. RESPONSE TIMES

1. Contractor‟s ability to meet specific response times and scheduled time frames of specific tasks.

2. Contractor‟s responsiveness/timeliness in providing administrative documents required by contract

3. Contractor‟s timeliness in responding to emergency service requirements (if foreseen by the contract).

C. BUSINESS RELATIONS

1. Contractor‟s ability to identify problems or potential problems and promptness in notifying the

Contracting Officer.

2. Contractor‟s ability to correct problems and prevent or mitigate potential problems in a timely manner.

3. Contractor‟s willingness to improve and correct non compliance issues or concerns.

4. Contractor‟s ability to use effective approaches and provide technical expertise and resources to solve contract problems.

5. Extent to which the contractor has demonstrated reasonable and cooperative behavior.

D. MANAGEMENT

1. Did Contractor dedicate adequate financial and human resources to the contract to meet its scope and objective(s)

2. Contractor‟s ability to select and retain cooperative and effective key personnel, such as but not limited to bilingual service call center and quality control personnel.

3. Extent key personnel were knowledgeable about contractual requirements.

4. Contractor‟s ability to provide adequately qualified personnel.

E. COMPLIANCE WITH ENVIRONMENTAL, SAFETY, HEALTH AND

SECURITY REQUIREMENTS

YES NO

1. Has the contractor received any notices of violations for noncompliance with environmental laws and regulations?

2. Has the contractor received any notices of violations for noncompliance with personnel safety requirements.

F. CONTRACTUAL CONSIDERATIONS

1. Has an election ever been made not to exercise an option or continue relations due to contractor‟s poor performance?

2. Has a cure notice or show cause ever been issued?

3. Did Contractor fail to observe any labor laws, collective bargaining agreements, use illegal labor etc?

4. Extent to which the contractor provided reliable, supportable cost estimates or proposals for contract changes or spare parts/materials.

G. OVERALL RATING OF CONTRACTOR

1. Overall rating of contractor‟s performance under this contract.

2. Would you award another contract to this contractor?

5. Has a Contract Discrepancy Report ever been issued?

REMARKS: (Please provide any desired rating elaboration and pertinent general comments in relation to the Contractor‟s contractual obligations) (Use additional sheets if necessary).

NAME OF RATER: __________________________________

FIRM: ______________________________________________