Past_Performance_Questionnaire_2_Apr_15.pdf

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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 Repair Hot

Temperature, Hot Water (HTHW) Phase 3 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 identified in Section C of page 2 of 8.

2. In order to ensure this questionnaire is considered, please forward this survey to arrive at the above address, no later than 2:00 PM (MST), 14 May 2015. Upon completion, please notify my office that the survey has been accomplished.

Name & Title of Individual

Name of Company

1 Attachment:

Past and Present Performance Questionnaire

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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: __________________________* Dollar Amount: __________________*

Contract Period or Dates of Performance: _______________________________________ *

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: ______________________________ Title: ____________________________

Address: _____________________ Telephone Number: _________________

_____________________________ Fax Number: ______________________

_____________________________ Email Address: _____________________

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

Mail:

10 CONS/LGCA

Attn: FA7000-15-R-0004/Ken Helgeson 8110 Industrial Drive, Suite 200 USAF

Academy, CO 80840-2315

Fax: 719-333-6608

E-mail: kenneth.helgeson.3@us.af.mil

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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/

Customers 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/

Customers 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.

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

E G S M U N

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.

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E G S M U N

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

2.13 The contractor demonstrated ability to conduct multi-phased renovation of an occupied building while minimizing construction effects to occupants during the contract period.

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

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

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

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

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

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

2.20 How well did the contractor apply piping insulation skills in

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2.21 How well did the contractor apply floor heating piping systems in projects?

2.22 How well did the contractor apply structural concrete form work in projects?

2.23 How well did the contractor apply concrete flatwork in projects?

2.24 How well was the contractor able to manage the work site in projects?

2.25 How well did the contractor plan and accomplish outages?

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

2.27 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.

3.4 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.

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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 How well did the contractor meet small business subcontracting goals and/or facilitate small business involvement in the project?

4.9 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.

YES/NO

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

YES/NO

5.4 Were liquidated damages assessed? If so, please explain: YES/NO

5.5 Additional Remarks:

5.6 Overall rating for this firm:

E G S M U