Past_Performance_Questionnaire.doc

FA8601-14-R-0010

13 December 2013

PAST PERFORMANCE QUESTIONNAIRE

Please complete this questionnaire based on the following guidance:

1. Handwritten responses are sufficient.

2. You are urged to supplement your own knowledge of the offeror’s performance with the judgment of others in your activity. In addition to completing the attached questionnaire for the identified program, we solicit your comments on other similar programs for which your activity has or has had contracts with this offeror. If you need more space than the comment sections provided, please attach a separate sheet to the end of this questionnaire.

3. Using the rating codes below, circle the rating that best describes the contractor’s work on the project. If an item is not applicable to your contract/order, or if you do not know how the contractor performed/is performing on that item circle N/A. If you rate a contractor less than (3) Satisfactory, please provide a narrative describing the exact nature of the deficiency. Circle Yes or No where applicable:

4. Some of the terms used in this questionnaire are related to government contracting. Commercial firms are requested to answer to the best of your understanding of these terms.

Based on the offeror's performance record, little doubt exists that the offeror will successfully perform the required effort.

Based on the offeror's performance record, some doubt exists that the offeror will successfully perform the required effort.

Based on the offeror's performance record, substantial doubt exists that the offeror will successfully perform the required effort. Changes to the offeror's existing processes may be necessary in order to achieve contract requirements.

Based on the offeror's performance record, extreme doubt exists that the offeror will successfully perform the required effort.

No performance record identifiable (see FAR15.305(a)(2)(iii) and (iv)).

5. Please e-mail or fax completed questionnaire to the office no later than 4:00 p.m. EST, 20 December 2013.

E-Mail: zachary.kauth.1@us.af.mil or

FAX response to ATTN: Lt. Zachary Kauth AFLCMC/PZIOB

(937) 904-3637.

If you have any questions, please contact Lt. Kauth at, (937) 522-4611.

I. RESPONDENT INFORMATION:

Name/Grade (Printed): _________________________________________________________________

Organization: _____________________________

E-Mail: __________________________

Phone: _____________________________________

FAX: __________________________

Position/Title: ________________________________________________________________________

Name of Company Being Rated: _________________________________________________________

Contract Number: ____________________________________________________________________

Relationship to Program: _______________________________________________________________

Length of Involvement in Program: ________________________________________________________

Name of Government or Corporate Contracting Officer

Tel:

II. QUESTIONS:

BACKGROUND

1. What type of work was contracted with this company? _____________________________________

2. Where was the work performed (i.e., local, nationwide, worldwide) ___________________________

Number of locations ______________

Number of facilities ________________

3. When was this work accomplished (period of performance)? ________________________________

Current Status? ( ) Active

( ) Complete

4. Was contract terminated prior to the agreed upon period of performance?

( ) Yes ( ) No

(Government contracts only.) If yes, explain. ____________________________________________

5. What was the annual dollar amount of the contract (Base Period and all Options)?

Base Period

Option I

Option II

Option III

Option IV

6. What was the total dollar amount of the contract (Base Period and all Options)? $_______________

7. What was the contract type? (T&M, FFP, IDIQ, Cost Reimbursement, e.g.) _______________

8. If applicable:

Number of Task Orders __________________ Dollar Amount _______________________

Number of Locations ____________________ Task Order POC _______________________

9. Did this company employ any subcontractor(s) to accomplish the required work? ( ) Yes ( )No

If subcontractors employed – approximate percentage of the work subcontractor(s) performed?_______%

10. Rate the contractor’s performance in effectively managing subcontractors. 5 4 3 2 1 N/A

11. Have any major contract requirements been terminated or rescheduled as a result of the contractor’s inability to perform?

( ) Yes ( ) No

12. Have any cure or show cause notices ever been issued?

( ) Yes ( ) No

If so, explain why and describe any corrective actions taken by the contractor to remedy the situation.

13. Has your organization ever elected to not exercise an option for this contractor? ( ) Yes ( ) No

If yes, please explain __________________________________________________________________

14. Were there any claims or litigation?

( ) Yes ( ) No

Rate the contractor’s performance in:

Materials, Man-hours and Equipment

1. The contractor demonstrated the ability to develop a workable plan to perform all contract requirements, including estimating quantities of all materials, man-hours and equipment.

5 4 3 2 1 N/A

Scheduling

1. The contractor effectively developed work schedules and crew assignments to comply with contract requirements and completion dates.

5 4 3 2 1 N/A

2. The contractor responded promptly to emergency situations and was able to fit them into their schedules.

3. The contractor had an effective number of employees to perform the requirements in the Performance Work Statement.

Personnel

1. The contractor hired qualified personnel to perform the services.

5 4 3 2 1 N/A

2. The contract manager and other key personnel had experience managing similar projects.

5 4 3 2 1 N/A

4. The contractor managed this contract efficiently and effectively.

5 4 3 2 1 N/A

Cost

1. Rate the contractor’s performance in accurately estimating/controlling costs to complete tasks within budget.

2. Were there any cost issues? If yes, please explain.

( ) Yes ( )No Quality

1. This company complied with the specific contract performance standards for each task area.

2. This company provided sound technical assistance, when responding to problems in a work area.

3. Rate the quality of work you received from this company.

5 4 3 2 1 N/A

Customer Satisfaction

1. Overall, how satisfied was your organization with the work accomplished by this company?

2. In a competitive situation, all other factors being equal, would you award this contractor another contract based on their past performance?

( ) Yes ( )No

3. Please feel free to provide any further information not covered in this questionnaire that you feel would be helpful in assessing the past performance of the offeror.

Please accept our sincere thanks for taking the time to complete this questionnaire. Your participation will be of great value to us.

E-Mail Completed Past Performance Questionnaire to:

Zachary.kauth.1@us.af.mil or fax to

(937) 904-3637

ATTN: Lt. Zachary Kauth, AFLCMC/PZIOB 1940 Allbrook Drive, Suite 3

Wright-Patterson AFB, OH 45433-5344

FA8601-14-R-0010

Past Performance Questionnaire