Atch_11_15-R-0002_Past_Performance_Questionnaire.pdf
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- Attached to
- Simplified Acquisition of Base Engineering Requirements (SABER) Federal contract opportunity
- Solicitation number
- FA9101-15-R-0002
About this file
Atch 11 15-R-0002 Past Performance Questionnaire
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Text version
Attachment 9 FA9101-15-R-0002
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:
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.
FA9101-11-R-0020
D. Please fax or email your completed questionnaire by 10 Business Days, prior to proposal due date TO:
AFTC/AEDC (ARNOLD) Commercial phone: (931) 454-5167 Attn: Robert Greene Commercial fax: (931) 454-7330 100 Kindel Drive, Suite A332 DSN phone: 340-5167 Arnold AFB TN 37389-1332 DSN fax: 340-7330 Email: Robert. Greene.17@us.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 SIGNATURE DATE
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