Past Performance Survey Comforters Blankets. Attch 4.pdf

FA7000-11-T-0019

Attachment 4

** FOR GOVERNMENT USE ONLY ONCE COMPLETED **

PAST PERFORMANCE SURVEY

This attachment will not be incorporated into the resultant contract.

THIS DOCUMENT, WHEN COMPLETED IS ONLY FOR VIEW BY THE GOVERNMENT.

This survey is for the United States Air Force Academy Contracting Office.

I. CONTRACT INFORMATION:

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

Contractor’s Name: _________________________________________________________

Address: __________________________________________________________________

Telephone Number: _________________________________________________________

Point of Contact: ___________________________________________________________

Project Title or Brief Description of Work: ______________________________________*

Contract Number: ___________________________________________________________*

Contract Value Per Year: $____________________________________________________

Contract Period or Dates of Performance: ________________________________________*

*Note: If offeror holds or has held more than one contract with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

II. SURVEY RESPONDENT INFORMATION:

Complete the following information on your company. You may be contacted for additional information pertaining to the past or present performance of the contractor identified in the section above. (The following information will assist in the analysis of the data. Information will be kept confidential.)

Name of Respondent: _______________________________________________________________________________

Company/Organization: ______________________________________________________________________________

Title: _____________________________________________________________________________________________

Address: __________________________________________________________________________________________

Telephone Number: ____________________________________ Fax Number:___________________________________

Relationship and time involved with Program/Contract:

Date you completed this questionnaire:____________________________________________________________________

FAX or E-MAIL COMPLETED SURVEY FORM TO:

FAX: LGCB ATTN: Michelle Desmarais, Contracting Specialist or Diana Myles-South, Contracting Officer, USAFA

CONTRACTING, FAX (719) 333-9103/9075

EMAIL: michelle.desmarais@usafa.af.mil

III. PERFORMANCE INFORMATION:

Choose the description of the contractor’s work that best reflects their performance using the descriptions provided below. Please provide a narrative explanation for any ratings of unsatisfactory, marginal, very good or exceptional and any other specific problems or annotations that would help us evaluate the contractor.

1 2 3 4 5 6 Exceptional Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets 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 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 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 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 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.

1 What type of comforters/blankets did this company provide you? Did they manufacture or were they a supplier of the blankets/comforters.

Comments:_____________________________________________________________________

2 Did the contractor meet the delivery within the timeframe given in the contract? Was the contractor early, on time, sometimes late, always late.

PLEASE ANSWER ALL QUESTIONS. PLEASE PROVIDE ADDITIONAL COMMENTS FOR EACH QUESTION

3 Rate the contractors overall performance in terms of quality of service and product.

4 Rate the contractor’s ability to plan for and execute quality control. Did the finished items show any problems that could have been avoided with good quality control? Did the contractor meet all quality control requirements stated by the specification?

5 Access the contractor’s ability to provide adequate resources (manufacturing facilities, competent management staff, quality control personnel, engineering manpower, subcontractors, etc) to support the contract effort. Did the contractor deliver what was promised?

6 Did the contractor keep you informed of any problems as they occurred and suggest solutions to the problem?

7 Access the contractor’s history of reasonable and cooperative behavior (e.g., communication, positive customer service, compliance with the order/contract terms and conditions, etc.)

THE FOLLOWING QUESTION IS "YES/NO" IN NATURE:

8. QUALITY/SCHEDULE/BUSINESS RELATIONS. Based on your judgment of the contractor’s performance, would you award another contract to this contractor for the same product again? Please explain.

( ) Yes ( ) No

Comments:______________________________________________________________________________________________

9. ADDITIONAL COMMENTS:

Thank you for you for completing this questionnaire.

The completed survey is to ONLY be viewed by the Government. Do not submit a copy of the completed survey to anyone other than jon.wilczynski@usafa.af.mil, Contract Specialist, or Diana South, Contracting Officer, at (719) 333-

9103.

****FOR OFFICIAL USE ONLY, ONCE COMPLETED****