Attachment___3__Past_Performance_Questionnaire.docx

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MACC Solicitation # FA5685-14-R-0013
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FA5685-14-R-0013
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FA5685-14-R-0009

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Offeror’s Name: ____________________ Telephone Number: ____________________ Address: __________________________ Fax Number: _________________________ __________________________ Point of Contact: ______________________

__________________________
__________________________

Project Title and Brief Description of Work: _____________________________________*

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.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ____________________________

Address: _____________________Telephone Number: ___________________ _____________________________Fax Number:_____________________
_____________________________Email Address: _____________________

C. FAX COMPLETED SURVEY FORM TO: 011-90-322-316-1090

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.

E
G
S
M
U
N
Exceptional
Good
Satisfactory
Marginal
Unsatisfactory
Neutral

Performance meets/met 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/met 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/met 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/did 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/did 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.

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

The contractor:
E
G
S
M
U
N
1.
Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.
2.
Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.
3.
Home office participated in solving significant local problems.
4.
Followed approved management plan.
5.
Provided effective quality control and/or inspection procedures to meet contract requirements.
6.
Corrected deficiencies in timely manner and pursuant to their quality control procedures.
7.
Provided timely resolution of contract discrepancies.
8.
Identified problems as they occurred.
9.
Suggested alternative approaches to problems.
10.
Displayed initiative to solve problems.
11.
Developed realistic progress schedules.
12.
Met established project schedules.
13.
Was responsive to contract changes.
14.
Provided adequate project supervision.
15.
Provided accurate and complete line item cost proposals including all aspects of work required for each task.
16.
Cooperated with Government personnel after award.
17.
How would you rate the contractor's overall performance on this contract?
18.
Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES/NO

19.
Would you award another contract to this contractor? If not, explain in “remarks.”

YES/NO

Remarks:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Attachment #2

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