Attachment 12 Past Performance Questionnaire.doc
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- FA7000-12-T-0024
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Attachment 12
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FA7000-12-T-0024
Attachment 12
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:____________________________________________________________________
E-MAIL COMPLETED SURVEY FORM TO:
Rachell Monteleone, Contract Specialist, rachell.monteleone@usafa.af.mil or if I’m unavailable, Diana Myles-South, Contracting Officer, diana.myles-south@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 |
| 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
QUALITY
| 1 |
| What product did the contractor provide for your organization (i.e., items similar to Flight Caps, Service Caps, or Parade Caps) |
Comments:_____________________________________________________________________
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 2 |
| Did the contractor deliver in accordance with contract schedule? Was the contractor on time, ever late, sometimes late, always late, always early: Comments:_____________________________________________________________________ |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 3 |
| Rate the contractors overall performance in terms of quality of service and product. Rated: |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 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? |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
SCHEDULE
| 5 |
| Rate contractor’s work in relation to commonly accepted professional standards such as production techniques related to good quality of seam finishes on items previously produced. Assess the contractor’s ability to perform (timely) in accordance with contract schedule. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 6 |
| Access the contractor’s ability to provide adequate resources (manufacturing facilities, competent management staff, quality control personnel, subcontractors, etc) to support the contract effort. |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
BUSINESS RELATIONS
| 7 |
| Did the contractor keep you informed of any problems as they occurred and suggest solutions to the problem? |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
| 8 |
| 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.) |
| 1 |
| 2 |
| 3 |
| 4 |
| 5 |
THE FOLLOWING QUESTION IS "YES/NO" IN NATURE:
9. QUALITY/SCHEDULE/BUSINESS RELATIONS. Based on your judgment of the contractor’s performance, would you award another contract to this contractor for the same services again? Please explain.
( ) Yes
( ) No
Comments:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
10. 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 Rachell Monteleone, Contract Specialist, at rachell.monteleone@usafa.af.mil, or Diana South-South Contract Officer, at diana.myles-south@usafa.af.mil.
****FOR OFFICIAL USE ONLY, ONCE COMPLETED****
PLEASE ANSWER ALL QUESTIONS. PLEASE PROVIDE ADDITIONAL COMMENTS FOR EACH QUESTION
*** FOR GOVERNMENT USE ONLY ONCE COMPLETED ***
PAGE
** FOR GOVERNMENT USE ONLY ONCE COMPLETED **
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