ATTACHMENT7.doc

RFP FA8501-07-R-0021

ATTACHMENT #7

SOURCE SELECTION INFORMATION - See FAR 3.104

SOURCE SELECTION SENSITIVE - FOR OFFICIAL USE ONLY

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

(This questionnaire, when filled in, shall be treated as Source Selection Sensitive in accordance with FAR 3.104-3 and shall not be disclosed to anyone outside of the Government Source Selection Team.)

A. Contractor Submitting Proposal: _________________________________________________________

Prime or Sub? ____________

B. Program Title ______________________________________________________________________

C. Program Description _____________________________________________________________________

D. Contract Number __________________________________

Contract Type ____________________________________

Contract Value Original: $__________________________

Current: $_______________________________________

E. Performance Period at Award: _______________________

Current: ________________________________________

F. If Award Fee Contract, what % of the fee has been awarded in each of the last 5 years?__________________________________________________________________

G. PLEASE FILL IN THE FOLLOWING RESPONDENT INFORMATION:

Name: _________________________________________

Agency: ________________________________________

Your Role Relative to contract (ACO, Inspector, Program Manager, Quality Assurance Evaluator, Engineer, Other explain): __________________________________________________________________________________

Complete Address: ________________________________________________________________________

Phone (DSN & COMM):______________________________________________________________

FAX (DSN & COMM): _____________________________________________________________________

E-mail Address: ___________________________________________________________________________________

PLEASE CHECK THE APPROPRIATE RATING FOR EACH OF THE FOLLOWING AREAS:

N/A=Not Applicable – self-explanatory. U=Unsatisfactory-Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective. M=Marginal-Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective. S=Satisfactory- Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory. V-Very Good-Performance met all contract requirements and exceeded some to the customer’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner. E=Exceptional-Performance met all contract requirements and exceeded many to the customer’s benefit. Problems if any, were negligible and were resolved in a timely, highly effective manner.

For any rating other than “N/A” or “Satisfactory”, please provide the rationale for the rating in “ADDITIONAL REMARKS”.

1. Quality/acceptability of services delivered.

2. Completion of work according to schedule.

3. Responsiveness to unscheduled requirements.

4. Performance of all technical requirements.

5. Timeliness of reports.

6. Sufficiency of material and personnel to accomplish task.

7. Responsiveness to contract changes/modifications.

8. Performance of contract requirements within agreed prices.

9. Competent/responsible/effective on-site manager.

10. Overall management performance.

11. Attitude (customer relations).

12. Effectiveness in managing subcontractors.

13. Adequately costs-out contract changes/modifications.

14. Responsiveness to items covered by warranty.

15. Adequacy of site clean-up.

16. Contractor’s overall performance.

17. Have there been any modifications or disputes/claims relative to the contract? ____ Yes _____ No

If Yes, explain: ________________________________________________________________________________________________________________________________________________

18. Has action been initiated to cancel or terminate for default? ____ Yes _____ No

If yes, explain: ________________________________________________________________________________________________________________________________________________

19. Given a choice, would you award to this contractor again? ____ Yes _____ No If no, explain: ________________________________________________________________________________________________________________________________________________

Strengths and/or Weaknesses: (Describe the contractor’s PREDOMINANT strengths and/or weaknesses.)

Strengths:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Weaknesses:_____________________________________________________________________________________________________________________________________

Additional Remarks for Rating Justification (Use additional pages if necessary)

Do you know of anyone else who can tell me about this contractor’s performance?

(Please list names, phone numbers and email address, if known.)

Name: ____________________________ Phone: ________________E-mail Address: ________________________

Name: ____________________________ Phone: ________________E-mail Address: ________________________

EVALUATOR SIGNATURE DATE