PAST PERFORMANCE QUESTIONNAIRE - Base Wide Flooring.docx

FOR OFFICIAL USE ONLY (WHEN FILLED IN IAW FAR 3.104-3)

PAST PERFORMANCE QUESTIONNAIRE

FOR

BASE-WIDE FLOORING

26 October 2010

Wright-Patterson Air Force Base (WPAFB), Ohio seeks your input regarding the past performance of a previous supplier for flooring and installation. The following questionnaire will be used as part of the Government’s evaluation of the offeror’s proposal for Flooring (i.e. carpet & tile) to be provided and installed on WPAFB. Please complete, sign and return the questionnaire directly to the Government. Questionnaires can be returned via email (Laura.Burnette@wpafb.af.mil), fax (937-656-1412). Only questionnaires received directly from respondents will be used in the evaluation. Signed and completed questionnaires must arrive not later than 4:00 P.M. (EST) on 9-Dec-10. Any questions should be directed to Laura Burnette at Laura.Burnette@wpafb.af.mil or (937) 522-4581.

a. E-mail signed and completed questionnaires as a file attachment in the Adobe Acrobat format (*.pdf). NOTE: Questionnaires returned via e-mail must contain a subject line that reads “FA8601-10-R-0088, Past Performance Questionnaire.” E-mail filters at Wright-Patterson Air Force Base are designed to filter e-mails without subject lines or with suspicious subject lines or contents (i.e., .exe or .zip files). Therefore, if the prescribed subject line is not included or the attachment is not in the Adobe Acrobat .pdf format, the e-mail may not get through the e-mail filters.

b. Fax signed and completed questionnaires to the attention of Laura Burnette, at (937) 656-1412. Please send an email alerting me that the information has been faxed.

c. Our areas of interest are summarized in the enclosed questionnaire. You are urged to submit your comments on similar programs/projects for which you had/have contracts or administer contracts with the offeror. Any additional information that you think would benefit WPAFB in our evaluation of the offeror’s proposal would be appreciated. Please note we may contact the offeror on problem areas or concerns identified to see what corrective actions have been taken or will be taken. The names of personnel responding to this questionnaire will not be provided to the offeror.

d. Thank you for your time and effort in helping us with this requirement.

PAST PERFORMANCE QUESTIONNAIRE

FOR

BASE-WIDE FLOORING CONTRACT

1. Contractor Being Evaluated:

a. Contractor’s Name: _________________________________________________

b. Contract Number: __________________________________________________

c. Program Title: _____________________________________________________

d. Period of Performance: ______________________________________________

e. Total Dollar Value: __________________________________________________

f. Is the contract fixed price? _____ Yes _____ No (If no, what type? __________)

2. Description of Products and Services Provided:

a. Contract/job size in square feet or square yards: __________________________

b. Did this contract/job occur in an occupied facility? _____ Yes _____ No

c. Was existing flooring removed? _____ Yes _____ No

d. Was system’s furniture present? _____ Yes ______ No

e. Were any asbestos-containing materials present in the existing conditions? If yes, were these materials abated? Please explain:_________________________

f. Was floor preparation involved? _____ Yes _____ No To what extent was floor preparation involved? ___________________________

g. Please list the products that were involved? ______________________________

h. Was this contractor selected on a competitive basis? _____ Yes _____ No Remarks: __________________________________________________________

i. What is the geographic distribution of products/services under this contract (i.e. local, nationwide, or worldwide)? ______________________________________

j. Number of locations serviced by this contract: ____________________________

3. Please respond to the following questions regarding the contractor’s past performance. Circle the word that represents your agreement or disagreement with statements regarding the contractor’s performance. Please provide additional comments for each question to help us fully understand your response.

Exceptional/High Confidence Offeror’s performance in the area of evaluation clearly exceeds requirements. Essentially no doubt that offeror will successfully perform the required effort.

Very Good/Significant Confidence Offeror’s performance in the area of evaluation met/meets all requirements and exceeded/exceeds some requirements in some areas. A few minor problems existed/exist but were/are managed effectively. Little doubt exists that the offeror will successfully perform the required effort.

Satisfactory/Confidence Offeror’s performance in the area of evaluation met/meets requirements. Problems existed/exist but were/are managed effectively. Some doubt exists that the offeror will successfully perform the required effort.

Marginal/Little Confidence Offeror’s performance met/meets most, but not all, requirements. Problems existed/exist in significant area(s) and management attention was/is needed. Substantial doubt exists that the offeror will successfully perform the required effort.

Unsatisfactory/No Confidence Offeror’s performance did/does not meet requirements. There were/are multiple problem areas. Offeror was/is generally ineffective. Extreme doubt exists that the offeror will successfully perform the required effort.

Not Applicable/Unknown Confidence Does not apply to offeror’s performance or have no knowledge of the offeror’s performance within the area of evaluation.

MANAGEMENT/PERSONNEL/STAFFING:

a. Were you satisfied with the company’s management of the contract? Please explain if dissatisfied.

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A Narrative: _______________________________________________________________

b. Was the contractor effective in interfacing with the government’s/industry staff? Were workers courteous?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Narrative: _______________________________________________________________

c. Did the contractor coordinate, integrate, and provide for effective subcontractor management?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Narrative: _______________________________________________________________

d. Did the contractor provide adequate numbers of qualified service technicians/installers to complete the contract/job or repairs?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Narrative: _______________________________________________________________

e. Did the contractor meet required completion schedules?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Narrative: _______________________________________________________________

f. Was the contractor able to support expedited start or completion dates due to mission priorities or to support after-hours (shift) work?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Narrative: _______________________________________________________________

g. Did the contractor maintain adequate resources for transportation of flooring products and supplies to include trucks and any material handling equipment?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

Narrative: _______________________________________________________________

QUALITY OF SERVICE:

a. Did the contractor comply with the specific contract performance standards for each task, and implement their own quality control?

_____ Yes _____ No (Please Explain)

Narrative: _______________________________________________________________

b. Were required proposals, reports/documentation submitted in a timely manner and were they complete and accurate?

_____Yes _____ No (Please Explain)

Narrative: _______________________________________________________________

c. If the work was accomplished in an occupied area, was the area cleared of debris daily? Was the area kept free of possible tripping hazards?

_____Yes _____ No (Please Explain)

Narrative: _______________________________________________________________

d. Did the company comply with all environmental management standards?

_____Yes _____ No (Please Explain)

Narrative: _______________________________________________________________

TERMINATION HISTORY:

a. Has this contract been partially or completely terminated for default or convenience?

_____Yes _____ No (Please Explain on the next page)

Narrative: _______________________________________________________________

b. Are there any pending terminations?

_____Yes _____ No (Please Explain)

Narrative: _______________________________________________________________

COST MANAGEMENT:

a. Did the contractor meet the proposed cost estimates? (Please mark best applicable with an X or checkmark.)

Less than estimated cost ( )

Comments: ____________________________________________________________________

GENERAL:

a. Based on your judgment of the contractor’s performance, would you award the contractor another contract?

_____Yes _____ No (Please Explain) Narrative: _______________________________________________________________

b. Overall, how satisfied were/are you with the work accomplished by this company?

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral Narrative: _______________________________________________________________

4. The following information will help us track the responses received, as well as resolve whatever differences may arise between your perception of the contractor’s performance and the contractor’s perception of their performance. You are advised that the offeror will be given an opportunity to respond to adverse past performance information. Names of personnel responding to this questionnaire will not be provided to the offeror.

a. Evaluator’s Name: __________________________________________________

b. Title: _____________________________________________________________

c. Telephone Number: DSN: Commercial: __________________________________

d. Organization, Office Symbol, and Address: _______________________________

e. Length of Involvement in the Contract: __________________________________

f. Date of Questionnaire Completion: _____________________________________

5. Thank you for your time and effort in assisting us with our requirement. Please use the space below for any additional information that would be helpful to the Government in evaluating the past performance of this offeror.

FA8601-10-R-0088

Base Wide Flooring