Attachment_5-_Performance_Questionnaire.doc

RFP: # FA8501-14-R-0011

ATTACHMENT # 5

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

GROUND MAINTENANCE

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOURSELF:

Name/Signature and Role Relative to Contract (e.g. Buyer, Program Manager):________________________________________________________

Agency or Business: ______________________________________________________________________________________________________ ________________________________________________________________________________________________________________________

Address: _______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________

Telephone No. _______________________________

FAX No. ____________________________________

Return your completed questionnaire either electronically, or by mail. See Section L of the solicitation for appropriate email address or mailing address

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

Part I. SPECIFIC PROGRAM INFORMATION.

Contractor/Business: _____________________________________________

CAGE Code: __________

Program Title and Brief Description: _____________________________________________________________________________________

Role in the Program/Work Performed As:

_____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 ____________

2. Current Schedule (assuming all options exercised): Beginning Date _________ through ____________

3. Reason for difference (if applicable) __________________________________________________________________________________

Contract Dollar Value:

1. Original MAX Contract $ Value (assuming all options exercised): ________________________________________________________

2. Current MAX $ Value (assuming all options exercised): ________________________________________________________________

3. Primary Causes of Changes: _______________________________________________________________________________

NOTE: In Part III., should your response be other than “satisfactory,” please provide supporting documentation in “Additional Remarks” on page 4 of 5 or on an additional sheet to this document (which is in word format). If supporting documentation is not provided for ratings that are other than “satisfactory,” the ratings will be considered to be unsubstantiated and will be interpreted as satisfactory.

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. Complete or comply with all aspects of the Contract?

2. Provide adequate program management to minimize risk?

3. Provide adequate and appropriate experience and skills for the task?

4. Provide sufficient resources (personnel) to accomplish the tasks?

5. Act with cooperation and flexibility to contract requirements?

6. Implement and/or have in place adequate Quality Assurance procedures?

7. Keep you informed of any problems that occurred in accomplishing the task?

8. Implement timely corrective measures for any problems with adequate thought and responsiveness

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

10. Displayed an attitude of respect and helpfulness to customer needs and personnel?

11. Completed Work on Time:

12.

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

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

15. Describe the contractor’s or company’s strong and/or weak points during the life of the contract. ________________________________________________________________________________________________________________________

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

17. Do you feel you “got what you paid for” ? Please explain. ____________________________________________________________________________

18. Additional Remarks.