Atch_03_PRESENT_PAST_PERFORMANCE_QUESTIONNAIRE.pdf

RFP FA8501-16-R-0004

ATTACHMENT #3

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

(FOR INFORMATIONAL PURPOSES ONLY; THE GOVERNMENT WILL SEND OUT

AND TRACK THE QUESTIONAIRE)

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOURSELF:

Name/Signature and Role Relative to Contract (e.g. Contract Administrator, Inspector, Project Engineer, Quality Assurance Evaluator, Other-explain):

Agency or Business:

Telephone: Fax Number:

RETURN YOUR COMPLETED QUSTIONAIRE VIA FAX NUMBER (478-926-4641). TO

ENSURE PROPER HANDLING OF THE INFORMATION, PLEASE CALL Leon Castellano (478-222-0963) BEFORE TRANSMITTAL.

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED

SENSITIVE AND SHALL NOT BE RELEASED TO THE OFFEROR.

PART 1. PROGRAM INFORMATION:

Contractor/Business:

Program Description: (Description of Project Scope of Work)

Contractor’s Role in the Program: ____Prime ____Subcontractor ____Vender/Supplier

Contract Number:

Number of Years?: Basic: _____ Option:_____

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

Contract Type(s): List all applicable contract types, i.e. Definitive C Type (specified project/task/repair/deliverable that is to be completed/delivered at a specified time), Requirements Ordering Type (A unspecified quantity of projects/tasks/repairs/deliverables that are to be completed/delivered at a unspecified time) , IDIQ Ordering Type (A unspecified quantity of projects/tasks/repairs/deliverables that are to be completed/delivered at a unspecified time and guarantees a specified minimum amount of work), SABER Ordering Type (A unspecified quantity of noncomplex construction projects that are to be identified at a unspecified time. The contract guarantees a specified minimum amount of work value. When the projects are specified, they are solicited among the awarded prime contractors to bid on), Etc.

Total Contract Amount: $ Status: ( ) Active ( ) Complete

Date of Award:

If completed, date of completion:

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

PART II. PERFORMANCE ASSESSMENTS:

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

N/A=Not Applicable – Self-explanatory. U=Unsatisfactory – Performance did not meet most contractual requirements. 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 contractual requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory.

V=Very Good – Performance met all contractual requirements and exceeded some to the customer’s benefit. E=Exceptional – Performance met all contractual requirements and exceeded many to the customer’s benefit. Problems, if any, were negligible and were resolved in a timely, highly effective manner.

Rate the following areas: N/A U M S V E

1 Quality/acceptability of completed work:

Contractor performed the contract requirements within the agreed prices:

3 Completion of work according to project schedule:

Effective management of material and personnel to accomplish contract requirements:

5 Provided reports/submittals in a timely manner:

Contractor’s effectiveness in coordinating and managing multiple subcontractors:

Contractor's ability to retain competent subcontractors throughout the project:

Contractor’s ability to assign and retain competent/responsible/effective on-site manager:

9 Provided accurate, timely, and complete line item cost proposals

Provided accurate, timely, and complete line item cost proposals for changes/modifications:

Demonstrated timely recognition and effective resolution of administrative, technical, vendor, and subcontractor problems affecting the project:

Demonstrated positive responsiveness to contract changes/modifications:

13 Working relationship with Government personnel after award:

14 Provided effective quality control and/or inspection procedures:

15 Corrected deficiencies in timely manner:

16 Contractor's responsiveness to items covered by warranty:

17 Contractor’s overall performance:

16. During a project with multiple trade disciplines, did the contractor manage the multiple subcontractors well? Please explain.

( ) Yes ( ) No ( ) N/A

17. Were you satisfied with the contractor’s coordination and management of multiple worksites operating simultaneously? Please explain. Please state approximately the average amount of projects the contractor works simultaneously. ( ) Yes ( ) No ( ) N/A

18. Has action been initiated to cancel or terminate the contract for default? ( ) Yes ( ) No If Yes, please explain.

19. Has there been any dispute/claim relative to the contract? ( ) Yes ( ) No If Yes, Please explain.

20. Describe the contractor’s or company’s strong characteristics.

21. Describe the contractor’s or company’s weak characteristics.

21. If given a choice, would you award to this contractor again? ( ) Yes ( ) No

22. Additional Remarks:

FOR OFFICIAL USE ONLY