Atach 6 Questionnaire Oct 10.docx

ATTACHMENT #6

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

FA8501-10-R-0002

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOUR COMPANY:

Name/Signature and Role Relative to Contract (e.g. Buyer, Program Manager):________________________________________________________ Agency or Business: ______________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ Address: _______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________ Telephone No. _______________________________ FAX No. ____________________________________

PLEASE COMPLETE ALL OF THIS QUESTIONNAIRE ON THE COMPANY LISTED IN PART I PARA A. RETURN THE COMPLETED QUESTIONNAIRE VIA FAX/ EMAIL AT (478) 926-7549 randall.miller.1@robins.af.mil. TO ENSURE PROPER

HANDLING OF THE INFORMATION, PLEASE CALL (478-327-6042) BEFORE TRANSMITTAL.

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SENSITIVE AND SHALL NOT BE RELEASED TO THE CONTRACTOR.

Part I.A. SPECIFIC PROGRAM INFORMATION.

Contractor/Business: _____________________________________________ CAGE Code: __________

Program Title and Brief Description: _____________________________________________________________________________________

PART I.B. Contractor’s Role in the Program: _____Prime _____Subcontractor _____Vendor/Supplier

Contract Number: ________________________________ Number of Years?: Basic:________ Option: _________

Contract Type(s): List all applicable contract types, i.e. Firm-Fixed-Price, Time & Materials, Cost, etc. _________________________________________________________________________________________________________________

PART II. GENERAL PROGRAM INFORMATION.

Period of Performance:

1. Original Schedule (assuming all options exercised): Beginning Date _________ through ____________

Contract Dollar Value:

NOTE: In Part III., should your response be other than “satisfactory,” please provide supporting documentation in “Additional Remarks” on page 4 of 5.

Please see rating assessment sheet for explanation of ratings.

PART III. PERFORMANCE ASSESSMENTS.

Please check the appropriate rating for each of the following questions:

N/A=Not Applicable U=Unsatisfactory M=Marginal S=Satisfactory V=Very Good E=Exceptional

1. Extent to which Company’s products and/or services met the specification/performance requirements:

2. Quality of Completed Product/Service:

3. Overall management of contracting efforts:

4. What is your rating of the quality of the contractor’s equipment and facilities:

5. Adequate Number of Dedicated Resources For Your Requirement:

6. Timely recognition and notification of administrative, scheduling problems affecting the performance:

7. Company performed independently without significant customer direction/oversight?

8. Monitoring of Program Schedules and Critical Milestones:

9. Completed Work on Time:

10. Company demonstrated positive responsiveness to unscheduled requirements or contract changes:

11. Has action been initiated to cancel or terminate the contract for default? If yes, explain. ________________________________________________________________________________________________________________________

12. Have there been any disputes/claims relative to the contract? If yes, explain.

13. Describe the contractor’s or company’s strong and/or weak points identified as a result of technical performance and any technical performance risk identified during the life of the contract. ________________________________________________________________________________________________________________________

14. If given a choice, would you award to this contractor again? If not, please explain. ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________

15. Do you feel you “got what you paid for” ? Please explain. _____________________________________________________________________

16. Additional Remarks.

FA8501-10-R-0002

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

ASSESSMENT RATING SYSTEM

E EXCEPTIONAL: Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD: Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY: Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL: Performance does not meet some contractual requirements. The contractual performance 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.

U UNSATISFACTORY: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE: Did not apply to this acquisition; or, questionnaire respondent has no knowledge of, and/or did not observe, the contractor’s performance in this area.

NOTICE TO QUESTIONNAIRE RESPONDENTS: Please do not transmit this page when faxing your input to the name/address listed on page 1.

SOURCE SELECTION SENSITIVE