PAST PERFORMANCE QUESTIONNAIRE 12.22.11.pdf

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

FA8601-12-R-0010

UPS/PDU Maintenance

PAST PERFORMANCE QUESTIONNAIRE

FOR

UNINTERRUPTIBLE POWER SUPPLY (UPS) AND POWER DISTRIBUTION UNIT

(PDU) MAINTENANCE

17 Nov 2011

Wright-Patterson Air Force Base (WPAFB), Ohio seeks your input regarding the past performance of a previous supplier UPS/PDU Maintenance. The following questionnaire will be used as part of the Government’s evaluation of the offeror’s proposal for UPS/PDU Maintenance to be provided on WPAFB. Please complete, sign and return the questionnaire directly to the Government. Questionnaires can be returned via email,(Ashley.cunningham@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 12:00 PM on 6 Jan 2012. Any questions should be directed to Lt Ashley Cunningham at Ashley.cunningham@wpafb.af.mil or (937) 522-4520.

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 “FA8601-12-R-0010, 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 Sara Blue, 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

UPS/PDU Maintenance and Repair Services

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 Services Provided:

a. Contract/job size (Large/Medium): __________________________

b. Was this contractor the Prime Contractor or a Subcontractor? (Please circle)

c. Was equipment serviced a Liebert and Powerware system? ____ Yes _____ No

d. Did this contractor perform Preventive Maintenance Service? _____Yes _____No

e. Did this contractor perform Emergency Maintenance Service? _____ Yes

______ No

f. Was this contractor selected on a competitive basis? _____ Yes _____ No

Remarks: __________________________________________________________

g. 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.

NUMERICAL

RATING

ADJECTIVAL

RATING

RATING DEFINITION

Exceptional

During the entire period, the contractor met and exceeded many of the requirements of the contract and consistently performed at a superior level. Performance was accomplished with very few minor problems, and the contractor took immediate and effective corrective actions for those problems that did occur.

Very Good

During the entire period, the contractor met and exceeded some of the requirements of the contract and consistently performed very well. Performance was accomplished with some minor problems, and the contractor took timely and effective corrective action for those problems that did occur.

Satisfactory

During the entire period, the contractor met the requirements of the contract and consistently performed at an acceptable level. Performance was accomplished with some problems, and the contractor took effective corrective action for those problems that did occur.

Marginal

During the entire period, the contractor did not always meet some of the requirements of the contract and intervention was required to continue performance. There were instances where performance was at a less than acceptable level; performance was accomplished with some problems and some corrective actions appear only marginally effective or were not fully implemented.

Unsatisfactory

During the entire period, the contractor did not meet the requirements of the contract and performance was at an unacceptable level. There were a number of serious problems that required extensive oversight and involvement, and corrective actions were either ineffective or non-existent.

N/A

Not Applicable

Unable to provide a rating. Contract did not include performance for this aspect, performance of this aspect was not observed or information necessary to rate this aspect is/was not available. Do not know.

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

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

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

d. Did the contractor provide preventative maintenance? If so, within what time frame was it provided?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

e. Was the contractor able to support emergency repair? If so, within what time frame was it provided?

Exceptional Very Good Satisfactory Marginal Unsatisfactory N/A

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)

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

_____Yes _____ No (Please Explain)

TERMINATION HISTORY:

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

_____Yes _____ No (Please Explain on the next page)

b. Are there any pending terminations?

_____Yes _____ No (Please Explain)

COST MANAGEMENT:

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

Less than estimated cost ( ) Comparatively equal to estimates ( ) Exceeded cost estimates ( ) Considerably surpassed estimates ( )

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.