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FA5685-15-R-0010
PAST AND PRESENT PERFORMANCE QUESTIONNAIRE
1. 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.
| 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:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________