Attachment_13_-_Past_Performance_Qustionnaire.pdf

Solicitation No. FA5703-13-R-0004

PAST PERFORMANCE QUESTIONNAIRE

FOR

TAXIWAY ALPHA REPAIR - PAVING

(The deadline for completion and submission of questionnaire is 11 Jan 2012)

I. CONTRACT INFORMATION: Complete the following information on the contractor that provided or is currently providing services for your company.

a. Contractor (Company/Name):

b. Contractor Address/Phone:

1. Contract Number/Title:

2. Period of Performance:

3. Services Provided (Explain, in some detail, the type of services provided by the contractor. Identify any performance history the contractor has provided relating to vehicle lease services.)

4. Total Contract Amount (to include all options):

II. PERFORMANCE INFORMATION: When responding to the following statements, choose the number on the scale of 1 to 5, which most accurately describes the contractor's performance.

If the statement is not applicable, circle (check) N/A. Additionally, include a short comment of every question. The numbers correspond with the following:

1 2 3 4 5 Unsatisfactory Marginal Satisfactory Highly Satisfactory Outstanding (Strongly Agree) (Disagree) (Neither Agree (Agree) (Strongly Agree) nor Disagree)

The Contractor:

1. Met established schedules. 1 2 3 4 5 N/A

Comments:

2. Provided experienced project managers and supervisors with the technical & administrative abilities needed to meet contract requirements. Demonstrated ability to replace personnel, if necessary, without interruption of services.

1 2 3 4 5 N/A

3. Hired only qualified and dependable personnel: 1 2 3 4 5 N/A

4. Provided effective quality control plans. 1 2 3 4 5 N/A

5. Were able to identify problem areas as they occurred. Displayed initiative to solve problems.

6. Provided timely, complete, accurate, and reasonable prices on items required on a project or modification. 1 2 3 4 5 N/A

7. Provided accurate invoices with backup documentation.

8. Provided an experienced quality control person. 1 2 3 4 5 N/A

9. Submitted customer reports in a timely manner. 1 2 3 4 5 N/A

III. SATISFACTION WITH CONTRACTOR: Circle (check) the number that best describes the contractor’s customer satisfaction.

1. Unsatisfactory: Contractor received Cure

Notice, Show Cause Letter, or Letter of

Concern.

2. Marginal: Customer complaints, either verbal or written.

3. Satisfactory: Customers expressed no displeasure with performance of the contractor.

4. Highly Satisfactory: Customer expressed verbal or written appreciation of the contractor’s performance.

IV. OVERALL RATING: Circle (check) the number that best describes your experiences with the contractor based on the comments below.

1. They were an unsatisfactory contractor: We would not want to contract with this firm again, under any circumstances.

2. They were a marginal contractor. Numerous problems developed that were a result of the contractor’s lack of cooperation and failure to perform work, as required.

3. They were a satisfactory contractor who met the minimum requirements of the contract.

Performance deficiencies improved when identified by the government. Although rework/warranty issues were performed, an aggressive quality assurance inspection program was required to ensure compliance.

4. They were a highly satisfactory contractor whom we would not hesitate to enter another contract. Problems encountered were minor and solutions were found with little difficulty.

5. They are an outstanding contracting firm in every respect. Problems were solved in a spirit of teamwork. Quality work, timely actions, and complete satisfaction were routinely achieved. We would pay premium prices to contract with them again.

V. ADDITIONAL COMMENTS:

VI. RESPONDENT IDENTIFICATION: Complete the following information on your company.

You may be contacted for additional information pertaining to the past and/or present performance of the contractor identified in section I above. A signature is required by the individual that completed this questionnaire. (The following information will assist in the analysis of the data. Information will be kept confidential)

a. Agency/Firm

b. Name:

c. Position & Title:

d. E-Mail Address:

e. Phone Number: Cell number:

f. Address:

g. Date you completed this questionnaire:

Signature/Date