Attachment 04 Past Performance Questionnaire.pdf

26 July 2012

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

Sample Cover Letter

(The format to be used shall be substantially as follows:)

Company: Date Address:

1. We are contemplating offering a proposal for a solicitation from the 10 Contracting Squadron located at United States Air Force Academy, CO. The solicitation is for the Mitchell Hall Renovation Phase 7 project. This proposal requires that we provide past performance information. Please complete the attached past performance questionnaire and return it via mail, fax or email to:

Mail:

10 CONS/LGCA

Attn: FA7000-12-R-0015/Audra Coppa 5226 Cedar Drive USAF Academy, CO 80840

Fax: 719-333-6608

E-mail: audra.coppa@us.af.mil

2. In order to ensure this questionnaire is considered, please forward this survey to arrive at the above address, no later than 30 August 2012 at 4:00 PM. Upon completion, please notify my office at __________ (phone number) that the survey has been accomplished.

Name & Title of Individual Name of Company

1 Attachment:

Past and Present Performance Questionnaire

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION:

Contractor’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.

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

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title: ____________________________

Address: _____________________ Telephone Number: ___________________ _____________________________ Fax Number: _____________________ _____________________________ Email Address: _____________________

C. RETURN COMPLETED QUESTIONNAIRE VIA MAIL, FAX OR EMAIL TO:

Mail:

10 CONS/LGCA

Attn: FA7000-12-R-0015/Audra Coppa 5226 Cedar Drive USAF Academy, CO 80840

Fax: 719-333-6608

E-mail: audra.coppa@us.af.mil

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 Exceptional, Marginal or Unsatisfactory. A block for the narrative is provided at the end of each Section for Quality of Work, Technical Performance, Schedule and Business Relations.

E G S M U N

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.

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.

was not observed or not applicable to the current effort being reported against.

Place an “X” in the appropriate column using the definitions matrix on the previous page.

1 Quality of Work

1.1 The contractor provided a quality finished project/product.

1.2 The contractor implemented procedures to find and correct performance discrepancies.

1.3 The contractor provided timely and complete documentation (includes, but not limited to, payroll reports, labor reports, progress reports, material submittals, shop drawings, and as-built drawings)

1.4 The contractor complied with all required federal, state, city, and local environmental policies and plans.

1.5 The contractor responded appropriately to any “Notices of Violations” from environmental enforcement authorities and took actions to correct the deficiency.

1.6 The contractor complied with safety standards and/or number of safety related incidents, code compliance, as applicable.

1.7 The contractor responded appropriately to any safety deficiencies received from the safety enforcement authorities (OSHA, Safety Office, etc.) and took actions to correct the deficiencies.

1.8 The contractor rectified any noted deficiencies in the work in a timely and efficient manner.

1.9 Please provide your observations regarding Quality.

2 Technical Performance

2.1 The contractor provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2.2 The contractor demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

2.3 If the project required contractor employee background checks prior to working in a government secure area or similar commercial environment, the contractor employees had no problems obtaining the necessary credentials.

2.4 The contractor complied with labor standards and documentation

2.5 The contractor’s crewmembers were knowledgeable with respect to the tasks assigned.

2.6 The contractor’s crewmembers possessed and used the appropriate Personal Protective Equipment (PPE).

2.7 The contractor’s tools and equipment were in safe condition and included all appropriate safety features.

2.8 The contractor’s crew kept the work site clear of trash and debris during the day and cleaned up the area at the end of each workday.

2.9 Construction activities were managed such that no ancillary damage was done to the building being worked on or adjacent buildings, property, rooms, or automobiles.

2.10 The contractor responded to project manager’s directives regarding any noted concerns of material appropriateness or installation procedures.

2.11 The contractor provided and effectively managed quality

subcontractors and ensured those subcontractors complied with all contract requirements.

2.12 The contractor demonstrated ability to conduct renovation of an occuppied building whiling minimizing construction effects to occupants during the contract period.

2.13 How has the contractor performed in projects involving containment and removal of asbestos, lead paint, and other hazardous material?

2.14 How well did the contractor apply carpentry skills in projects?

2.15 How well did the contractor apply plumbing skills in projects?

2.16 How well did the contractor apply electrical skills in projects?

2.17 How well did the contractor apply mechanical skills in projects?

2.18 How well did the contractor apply painting skills in projects?

2.19 How well did the contractor apply heating, ventilating and air conditioning (HVAC) skills in projects?

2.20 How well did the contractor apply pipe fitting skills in projects?

2.21 How well did the contractor apply sheet metal skills in projects?

2.22 How well did the contractor apply welding skills in projects?

2.23 How well did the contractor apply excavation skills in projects?

2.24 How well did the contractor apply demolition skills in projects?

2.25 How well did the contractor apply masonry skills in projects?

2.26 How well did the contractor install and/or integrate Notifier Fire suppression system or other brand of fire suppression system in projects?

2.27 How well did the contractor apply insulation skills in projects?

2.28 How well did the contractor apply structural slab/stell skills in

2.29 How well did the contractor apply retaining wall skills in projects?

2.30 How well was the contractor able to manage the work site in

2.31 How well did the contractor apply security hardware installation skills in projects?

2.32 How well did the contractor perform in understanding the significance and preserving nationally historic landmarks, monuments, buildings, etc., during construction projects?

2.33 Please provide your observations regarding Technical

Performance.

3 Schedule

3.1 The contractor developed a realistic progress schedule and maintained scheduled progress.

3.2 The contractor was responsive to changes and provided complete, accurate and reasonable cost proposals that met the requirements of the stated change request.

3.3 The contractor took immediate corrective actions to improve schedule problems, if applicable.

3.34 Please provide your observations regarding Schedule.

4 Business Relations

4.1 The contractor was available to discuss the contract and project requirements during construction to meet the contract requirements.

4.2 The contractor identified problems as they occurred, displayed initiative to solve the problems and offered alternative solutions to problems encountered during the project.

4.3 The construction project manager or superintendent had the authority to carry out the day-to-day operations of the project.

4.4 The contractor paid their employees, subcontractors and/or suppliers in a timely manner. Address any problems in the narrative.

4.5 The contractor provided the appropriate guarantees, warranties and other required close out documents such as as-built drawings, manuals and other such documentations as required by contract.

4.6 How would you rate the relationship between the contractor and client’s/customer’s team?

4.7 How would you rate the overall corporate management, reasonableness and cooperative conduct of the contractor?

4.8 Please provide your observations regarding Business Relations.

5 Summary

5.1 Would you award another contact to the company being evaluated?

If no, please explain.

YES/NO

5.2 Was the customer satisfied with the finished product? If no, please explain.

5.3 Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:

5.4 Were liquidated damages assessed? If so, please explain:

5.5 Additional Remarks:

5.6 Overall rating for this firm:

E G S M U