Attch-4-Stator_Blade_Past_Performance_Questionnaire.pdf

ATTACHMENT #4

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION 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 ten (10) 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:

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.

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.

D. Please fax or email your completed questionnaire by 13 February 2013, no later than 2:00PM CST to:

AEDC/PZI Commercial phone: (931) 454-5166

Attn: Henry Daniels Commercial fax: (931) 454-7330

100 Kindel Drive, Suite A332 DSN phone: 340-5166

Arnold AFB TN 37389-1332 DSN fax: 340-7330

Email: Henry.Daniels@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:

6. Detailed description of service provided: (include compressor rotor or stator blade material/type) Provide a separate attachment describing services provided.

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

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

Substantial Confidence Satisfactory Confidence Limited Confidence

No Confidence Unknown Confidence (Neutral)

Comments: ________________________________________________________________________

2. What was the quality of work performed by the contractor?

Comments:___________________________________________________________________________

3. How well did the contractor comply with the requirements of the contract?

Comments: ________________________________________________________________________

4. Was the work accomplished as proposed by the contractor?

5. What was the quality and detail of the Test Plans, Tests, Certifications, and Test Examinations used during product acceptance testing?

Comments: _________________________________________________________________________

6. How well did the contractor communicate submittals, progress schedule, and progress reports?

7. How well did the contractor perform against the delivery schedules of the contract? In the comments, specify if the contractor met, exceeded, or failed to meet contractual delivery dates and, if schedule slips occurred, state the number of slips and cumulative schedule variance.

8. How well did the contractor meet forecasted costs?

9. How timely and effectively did the contractor resolve contract problems?

10. How adequate did the contractor prepare, package, and protect the fabricated equipment to prevent damage or degradation during transportation back to the Customer?

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

12. Were API 687 standards applicable? (Yes or No)

EVALUATOR SIGNATURE DATE