11R6 attach 4.docx

FA8751-11-R-0006

ATTACHMENT #4

PAST PERFORMANCE QUESTIONNAIRE COVER SHEET

Cover letter for Past Performance Questionnaire FROM: Air Force Research Laboratory Specialized Acquisition & Operational Contracting Branch (AFRL/RIKO)

SUBJECT: REQUEST FOR PAST PERFORMANCE INFORMATION FOR SOLICITATION:

FA8751-11-R-0006 REPAIR FIRE ALARM SYSTEM AIR FORCE RESEARCH LABORATORY/ROME RESEARCH SITE (AFRL/RRS)

Our office is in the process of selecting a contractor for the subject construction project. One of the award criteria includes the evaluation of the Offeror’s past performance on prior or current contracts. We need your assistance by rating the Offeror’s past performance on the attached Past Performance Questionnaire form.

If you have any questions regarding the questionnaire please do not hesitate to contact the Contract Specialist Mr. Bryant Soule.

Instructions for completing the questionnaire:

In advance, we know your time is valuable and appreciate your support by completing the questionnaire.

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION FA8751-11-R-0006

Offeror:

Contract Number:

Project Title:

Location:

Type of Contract: ____Fixed Price ____ Cost Reimbursable Participated as: ____ Prime Contractor ____Subcontractor Original Award Amount: ________________________ Final Amount: ______________________ Contract Completion Date (CCD) (original): ________________ CCD (final): _________________ Award Date: _________ Percentage of Work Accomplished by Your Firm:

Project Description:

Contracting Office/Customer POC:

Name/Code

Organization

Address

Telephone Number(s) Facsimile Number(s)

Email Address

PAST PERFORMANCE QUESTIONNAIRE

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

E (EXCELLENT) – Performance meets contractual requirements and exceeds the Government’s expectations. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

G (GOOD) – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance of the element 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 of the element contains some minor problems for which corrective action taken by the contractor appear or were satisfactory.

M (MARGINAL) –Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. 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 of the element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N (NEUTRAL) – No relevant past performance record is identifiable upon which to base a meaningful performance risk prediction. A search was unable to identify any relevant past performance information for the contractor or their key personnel. (This is neither a negative nor positive assessment.)

PLEASE PROVIDE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. Was this a competitive Contract? (Yes or No)

2. Role of contractor (Prime or Sub-Contractor)

3. Contractor completed all work with good workmanship and in conformance with the specifications, resulting in minor, if any, punchlist items.

4. Performance was cost effective. There were minimal cost increases to the original negotiated amount. If there were significant changes, please explain below.

5. Contractor’s accuracy regarding the pricing of contract modifications and providing appropriate back-up documentation?

6. Contractor provided materials and products that met or exceeded contract requirements.

7. Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements.

8. Contractor developed and submitted realistic progress goals.

9. Effectiveness of on-site management, including management of subcontractors?

10. Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

11. Ability to successfully respond to emergency and/or surge situations.

12. Contractor was responsive during contract performance on administrative issues.

13. Safe work habits demonstrated through proper and adequate use of protective equipment and job site protection to maintain accident-free work zone.

14. Responsiveness regarding safety issues.

15. Contractor’s accuracy regarding monthly invoices with appropriate back-up documentation and monthly status reports/budget variance reports.

16. Ability to hire/apply a qualified workforce to this effort.

17. Ability to retain a qualified workforce on this effort

18. Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client.

19. Contractor provided timely and satisfactory response to warranty issues after project completion.

20. (Yes or No) Has/was this contract partially or completely terminated for default or convenience or are there any pending terminations? If Yes, please elaborate in comment section below.

21. (Yes or No) Indicate if show cause or cure notices were issued or any default action. If Yes, please elaborate in comment section below.

22. (Yes or No) Have there been any indications that the contractor has had any financial problem or was not properly paying subcontractors or not paying them on time? If Yes, please elaborate in comment section below.

23. In summary, provide an overall rating for the work performed by this contractor.

COMMENTS: Objective Comments/ concerns relating to this Offeror.

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION – SEE FAR 2.101 and 3.104 (Derived from: IG5336.9201, JAN2008)