Atch 9 11-R-0020 Past Performance Questionnaire.docx

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SIMPLIFIED ACQ OF BASE ENG REQ (SABER) Federal contract opportunity
Solicitation number
FA9101-11-R-0020
Issued by
Department of the Air Force Materiel Command Test Center

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Atch 9 11-R-0020 Past Performance Questionnaire

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Attachment 9 FA9101-11-R-0020

FA9101-11-R-0019

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTIN SENSITIVE

IAW FAR 2.101 AND 3.104

CONTRACTOR: __________________________

I. Background

The purpose of this questionnaire is to obtain past performance information relative to contracts that have previously been completed within the past five years or are currently being performed by the contractor identified above. This company is a potential source for performing a Firm Fixed Priced contract. Your assistance in evaluating the contractor’s past performance is deeply appreciated.

II. Instructions

Please complete the questionnaire based on the following guidance:

A. Legible handwritten responses are sufficient. Indicate based on the description below, the contractor’s performance on the identified program in the assessment area. Assessments should reflect only contractor liable performance. The following is a definition of the scoring levels:

Rating
Definition
Substantial Confidence
Based on the offeror’s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort.
Satisfactory Confidence
Based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.
Limited Confidence
Based on the offeror’s recent/relevant performance record, the Government has a low expectation that the offeror will successfully perform the required effort.
No Confidence
Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.
Unknown Confidence (Neutral)
No recent/relevant performance record is available or the offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

B. Please provide comments for all questions in which a “No Confidence”, “Limited Confidence”, or “Satisfactory Confidence” rating is given and as appropriate for all other answers. Space for your comments is provided in each area. If more space is needed, attach additional sheets to the end of the questionnaire and reference the respective question.

C. You are urged to supplement your own knowledge of the offeror’s performance with the judgment of others in your organization. In addition to completing the attached questionnaire for the program, we solicit your comments on other similar programs for which your office has contracts with this offeror.

D. Please fax or email your completed questionnaire by 1 August 2011, no later than 2:00PM CST to:

AEDC/PKECommercial phone: (931) 454-5167
Attn: Robert GreeneCommercial fax: (931) 454-7330
100 Kindel Drive, Suite A332DSN phone: 340-5167
Arnold AFB TN 37389-1332DSN fax: 340-7330
Email: Robert. Greene@arnold.af.mil

Our goal is to select the best value to the Government. Your past performance evaluation is a factor in determining the best value. The following information will assist in the analysis of the data and will be kept confidential.

III. Contractor Identification:

A. Evaluating Company Information:

1. Company Name/Address: ____________________________________________

2. Evaluator’s Name: __________________________________ _______ _

3. Title:

4. Phone Number:

B. Performance Evaluation of:

1. Contractor:

2. Contract number:

3. Period of Performance:

4. Negotiated price or cost at award:

5. Current estimated contract dollar amount:

IV. Past Performance Evaluation (Circle the word corresponding to your rating)

1. How would you rate the contractor’s overall performance on the project?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments: ________________________________________________________________________

2. Provided effective quality control and/or inspection procedures to meet contract requirements?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments: ________________________________________________________________________

3. Effectively managed subcontractors (if used)?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments: _________________________________________________________________________

4. Corrected deficiencies in a timely manner and pursuant to their quality control procedures?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. Developed realistic progress schedules? Met established project schedules?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

6. How effective was the contractor at dealing with management issues? Were supervisors and managers experienced and knowledgeable?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. Was Contractor responsive to contract changes?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

8. Did the Contractor effectively communicate daily scheduled activities?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. What was the attitude toward safety? Was the contractor proactive at resolving safety issues or concerns?

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

10. Would you enter into another contract with this company?__________________________________

____________________________________
EVALUATOR SIGNATUREDATE

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