Attachment2Questionnaire.pdf

SOURCE SELECTION INFORMATION

SEE FAR 2.101 AND 3.104

RFP FA8533-13-R-30278

ATTACHMENT 2

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT YOURSELF:

Name and Role Relative to Contract (e.g. Buyer, Program Manager):________________________________ ____________________________________________________________________________________________B usiness:_______________________________________________________________________________________ Address:

Telephone No. _______________________________ FAX No. ____________________________________

Return your completed questionnaire via fax to (478) 222-1854 or electronically mail to Desura.Gates@robins.af.mil or Elizabeth.Midkiff@robins.af.mil . Please Call (478) 222-1908 or (478) 222 -1907, respectively before transmitting by fax to ensure confidentiality.

NOTICE: WHEN COMPLETED, THIS QUESTIONNAIRE WILL BE CONSIDERED SOURCE SELECTION

SENSITIVE INFORMATION AND WILL NOT BE RELEASED TO THE OFFEROR.

Part I. SPECIFIC PROGRAM INFORMATION:

Name of Contractor: _____________________________________________ CAGE Code: __________

Program Title and Brief Description:

Contractor’s Role in the Program: _____Prime _____Subcontractor _____Vendor/Supplier

Contract Number: ________________________________ Number of Years? ____________________

Contract Type(s), i.e. Firm-Fixed-Price, Time & Materials, Cost, etc:

PART II. GENERAL PROGRAM INFORMATION:

Period of Performance (assuming all options exercised) of Contract or Effort: Beginning Date _________ through

Current Dollar Value: ______________________

PART III. PERFORMANCE ASSESSMENTS:

1. Have there been any disputes/claims relative to the contract, or action of any kind to terminate performance? If yes, explain.

2. Describe the contractor’s strong and/or weak characteristics:

3. If given a choice, would your company award to this contractor again? If not, please explain.

TABLE

Please check the appropriate rating for each of the following questions in the table below. Should your response be other than “satisfactory,” please provide supporting documentation 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 to be “satisfactory.”

PERFORMANCE AREAS Not

Applicable Unsatisfactory Marginal Satisfactory Very Good Exceptional

1. Extent to which Company’s products and/or services met the requirements of the customer’s contract or project:

2. Company’s level of workmanship and quality in the products and services provided on the contract:

3. Company’s proficiency with processing the customer’s contract or project including timely initiation of work, timely deliveries of products/services, and invoices:

4. Customer’s satisfaction with the company’s response to warranty claims, corrective actions, product recalls, and/or other “after the sale” actions:

5. Company’s level of attention to detail, responsiveness to customer concerns/questions/inquiries, and promptness in submitting data (including technical reports and/or management status reports) – during the performance of the contract.

6. Company’s knowledge and proficiency with industry specifications and standards, for example:

American Petroleum Institute (API), American Welding Society (AWS), National Fire Protection Association (NFPA), American Society of Mechanical Engineers (ASME) , Occupational Safety and Health Administration (OSHA), etc.

7. Extent to which Company utilized small businesses, veteran-owned small businesses, small disadvantaged businesses, and other such socio-economic business sectors in its contract performance:

RFP FA8533-13-R-30278

PAST/PRESENT PERFORMANCE QUESTIONNAIRE

ASSESSMENT RATING SYSTEM

E EXCEPTIONAL: Performance meets contractual requirements and exceeds many requirements. 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. 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.