Past_Performance_Qustions.pdf

FA7000-13-R-0008

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

PAST PERFORMANCE SURVEY

U.S. Air Force Academy

This document is to be completed by companies/customers the offeror has provided/is providing services for.

This attachment will not be incorporated into the resultant contract.

The document, when completed is only for view by the Government.

For Official Use Only (when completed)

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/Services provided_______________________________________________________________*

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. 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. Personal information will be kept strictly confidential (e.g., name of the respondent, phone and fax number, title, and relationship and the time involved in the contract.)

Company Name: ______________________________________________________

Name of Respondent: __________________________________________________

Title: _______________________________________________________________

Address: ____________________________________________________________

Telephone Number: ___________________________________________________

Fax Number: ________________________________________________________

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

Relationship and time involved with Program/Contract:

Date you completed this questionnaire:

E-MAIL COMPLETED SURVEY FORM TO:

Jerry B. Smith, USAFA CONTRACTING SPECIALIST at the following address

E-MAIL: jerry.smith.25@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.

RATING DEFINITION

Exceptional (Code E):

Very Good (Code VG):

Satisfactory (Code S):

Neutral (Code N):

Marginal (Code M):

Unsatisfactory (Code U/S):

The contractor provided excellent performance. Meets contractual requirements, had excellent deliveries, quality, and exceeds many requirements.

The contractor's performance meets contractual requirements, had good deliveries, quality and exceeds some requirements.

The contractor met the minimum requirements of the contract with little disruption of schedule or contract performance.

Unable to provide a score.

Contractor was consistently late with deliveries.

Contractor did not meet minimum requirement and late with deliveries majority of the time

1. Did the contractor provide maintenance services, and if so, how well did the contractor provide those services, e.g., assess contractor’s ability to respond to requests for maintenance and resolve problems?

( ) Unsatisfactory ( ) Marginal ( ) Neutral

( ) Satisfactory ( )Very Good ( ) Exceptional

Comments:_____________________________________________________________________________________________

2. Did the contractor provide services for the maintenance of food service equipment, and if so, how well did the contractor provide those services, e.g., assess how well the contractor kept track of the preventative maintenance requirement?

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

Comments:_____________________________________________________________________________________________

3. Did the contractor provide repair parts in a timely manner, and if so, how well did the contractor provide those services, e.g., assess contractor’s ability to maintain a “bench stock”?

Comments:_____________________________________________________________________________________________

4. Did the contractor respond to requests for emergency repair within the required time frame, and if so, how well did the contractor provide those services, e.g., assess the contractor’s ability to satisfy the requirement for emergency repair during non-duty hours after notification?

Comments:_____________________________________________________________________________________________

5. Did the contractor maintain appropriate certifications, e.g., Type I EPA certification for Federal Clean Air Act, Section 608;

critical commercial/industrial equipment training credentials; e.g., Hobart, Baxter, and Monster Fryer.

Comments:_____________________________________________________________________________________________

6. Did the contractor perform work that met or exceeded acceptable levels?

Comments:_____________________________________________________________________________________________

7. Did the contractor suggest alternative approaches to problems and display initiative to solve problems?

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

Comments:_____________________________________________________________________________________________

8. Did the contractor maintain appropriate interaction with food service personnel, in a collaborative environment?

Comments:_____________________________________________________________________________________________

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:____________________________________________________________________________________________

Thank you for your time in filling out the 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 Jerry Smith Contract Specialist, at jerry.smith.25@us.af.mil or (719) 333-3587.

mailto:jerry.smith.25@us.af.mil