Attachment_6__Past_Performance_Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IN

ACCORDANCE WITH FAR 2.101 AND 3.104

FA875119RA004

ATTACHMENT 6

PAST PERFORMANCE QUESTIONNAIRE

15 JULY 2019

INSTRUCTIONS FOR OFFEROR:

1. Section A: The Offeror will complete Section A of the questionnaire (Page 2 &3) for each reference and include with their proposal.

2. Section B: The Offeror will complete Block 2 of Section B of the questionnaire (Contract number and Program Name) and submit Section B directly to their references. Offeror will request the reference return the questionnaire directly to the Contract Specialist identified below.

PROPOSAL RESPONSE DATE: 14 August 2019

CONTRACT SPECIALIST

NAME: Leslie Christoferson

TEL: (315) 330-7255

EMAIL: leslie.christoferson@us.af.mil

MAIL: AFRL/RIKO

ATTN: Leslie Christoferson 26 Electronic Pkwy Rome NY 13441-4514

PAST PERFORMANCE QUESTIONNAIRE

SECTION A:

Offerors will complete Section A of the questionnaire (Pages 2 & 3) for each reference and include with their proposal.

1. Company Name/ Reference Name: __________________________________________

Address: ___________________________________________________________________

Tel: ___________________________ Fax: _____________________________

Email: ____________________________________________________________________

2. Contract #: _______________________ Program Name: ___________________________

3. Contracting Officer (if different from reference): _________________________________________

Address: ____________________________________________________________________

Email: ____________________________________________________________________

4. Contract Type: Firm-Fixed Price Cost-Reimbursement Other (describe)

5. Description of Work: ___________________________________________________________

6. Brief Description of the Effort: Prime ____ or Subcontractor ____

PAST PERFORMANCE QUESTIONNAIRE

7. Award Date: ______________________ Scheduled Completion: ______________________

Final Completion Date (if different): ______________________

8. Amount Per Year: ___________________ Contract Total Amount: _____________________

Final Amount (if different): _________________________________________________

9. Comments regarding compliance with contract terms and conditions:

10. Comments regarding any known performance deemed unacceptable to the customer, or not in accordance with the contract terms and conditions:

11. List all major subcontractors that worked on referenced project, in what trade, and what percentage of work done: ______________________________________________________________________________

PAST PERFORMANCE QUESTIONNAIRE

Past Performance Questionnaire

SECTION B: Past performance reference completes this entire Past Performance Questionnaire section.

INSTRUCTIONS FOR REFERENCE

You have been provided as a past performance reference in response by the Offeror to solicitation FA875119RA004

– Simplified Acquisition of Base Engineering Requirements (SABER) at the Air Force Research Laboratory’s Information Directorate, Rome NY. In order for the Government to evaluate the past performance of the Offeror providing you as a reference, please complete Section B, Past Performance Questionnaire, and return it to the Contract Specialist identified below. The Contract Number/Program Name provided by the Offeror are found in Block #2 below. If the Offeror performed additional contracts for your organization, please provide past performance information on those contracts as well.

Response Date: 14 August 2019

Leslie Christoferson, Contract Specialist

AFRL/RIKO

26 Electronic Pkwy Rome NY 13441-4514 Tel: (315) 330-7255 or DSN 587-7255 Fax: (315) 330-2555 E-Mail: leslie.christoferson@us.af.mil

The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable. Thank you for your assistance.

1. Name: ____________________________________________________________________

Position: ____________________________________________________________________

Address: ____________________________________________________________________

Email: ________________________________________________________________

2. Contract #:_______________________ Program Name: _________________________

Date Completed: ________________________

3. Relationship and time involved with Offeror:

PAST PERFORMANCE QUESTIONNAIRE

4. What, if any, elements of work were subcontracted? Please estimate the percentage of the total work that was subcontracted?

SECTION B, CONTINUED: Please rate the offeror’s performance using the scale below.

E G S M U N Exceptional Good Satisfactory Marginal Unsatisfactory Neutral Performance meets contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements.

The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

does not meet some contractual requirements.

The contractual performance of the element or sub-element 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.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

was not observed or not applicable to the current effort being reported against.

PAST PERFORMANCE QUESTIONNAIRE

EVALUATION AREAS

I. Quality E G S M U N

1.

Contractor provided effective quality control and inspection procedures that resulted in a quality-finished project.

2. Contractor developed and submitted realistic progress goals.

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

4.

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

5.

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

Comments:

II. Timely Performance E G S M U N

Contractor met established frequency requirements to complete the project on time and to ensure quality results.

2.

Contractor performed all work without the issuance of a cure notice or show cause letter. (If a notice was issued, please describe the circumstances in the comments section and identify how the situation was resolved.)

3. Contractor provided timely proposals and responses to contract changes, if any.

4.

Contractor submitted progress schedules and interim progress reports, as required, in a timely manner.

5. Contractor provided submittals on time as required.

6. Contractor provided timely resolution of all punch list items.

III. Management Effectiveness E G S M U N

Contractor provided experienced, qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

PAST PERFORMANCE QUESTIONNAIRE

15 JULY 2019

2. Contractor hired quality subcontractors and effectively managed and coordinated their work.

3.

Contractor ensured the site superintendent had sufficient authority to make decisions and take actions during project performance to keep the project on schedule.

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

5. Contractor paid employees/subcontractors/suppliers fully and on time.

6.

Contractor cooperated to resolve problems, attended meetings, and maintained effective communication to ensure satisfactory resolution.

IV. Contract Administration E G S M U N

1. Contractor provided complete and correct documentation in a timely manner.

2.

Contractor was responsive during contract performance on administrative issues.

V. Compliance with Safety Standards E G S M U N

1. Adequacy of Safety Plan.

2. Implementation of Safety Plan.

3.

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

4. Response to incidents was timely, reports were made as required, and collateral risk was mitigated promptly. If no incidents for the project, write N/A.

VI. Overall Performance E G S M U N

1. Please rate the contractor’s overall performance.

ADDITIONAL COMMENTS (attach additional sheets as necessary):

PAST PERFORMANCE QUESTIONNAIRE