Attachment_20_Past_Performance_Questionnaire.doc

PAST PERFORMANCE QUESTIONNAIRE

TITLE: INDEFINITE DELIVERY-INDEFINITE QUANTITY CONSTRUCTION

FEDERAL LAW ENFORCEMENT TRAINING CENTER

CHARLESTON, SOUTH CAROLINA

(This questionnaire, when filled in, shall be treated as Source Selection Information in accordance with FAR 3.104-3 and shall not be disclosed to anyone outside the Government Source Selection Team)

Contractor__________________________ Contract Number: _______________

( Prime? ( Sub?

FFP? (YES (NO – If no, specify:

Contract Value (Original): $_______________________

(Current) $_______________________ If Award Fee Contract, What % of the fee has been awarded in each of the last 3 years?

Contract Start & Completion:____________________

If contractor is behind schedule, list primary causes:

Program Description: (Description of Project Scope of Work)

PLEASE FILL IN THE FOLLOWING RESPONDENT INFORMATION:

NAME: __________________________________ Role relative to contract:

ADDRESS: __________________________________

__________________________________ (ACO, Inspector, Contract Administrator, Project Engineer, Buyer, Quality Assurance Evaluator, Other-explain)

FAX No: .__________________________________

PLEASE CHECK THE BOX RELATING TO THE APPROPRIATE RATING FOR EACH OF THE FOLLOWING AREAS:

NA=Not Applicable, U=Unsatisfactory, M=Marginal, S=Satisfactory, A=Above Average, O=Outstanding

For any rating of “Unsatisfactory” or “Marginal”, please provide (1) Rationale for rating, (2) Indication of contractor problem notification, and (3) Contractor’s corrective action, as applicable, in “Additional Remarks”.

1. Quality/acceptability of services delivered

2. Completion of work according to schedule

3. Responsiveness to unscheduled/emergency requirements

4. Performance of all technical requirements

5. Responsiveness to contract changes/ modifications

6. Timeliness of proposal submissions/other reports

7. Sufficiency of material and personnel to accomplish tasks

8. Performance of contract requirements within agreed prices

9. Competent/responsible/effective on-site managers

10. Overall Program Management

11. Attitude (customer relations)

12. Effectiveness in managing subcontractors

13. Adequately prices contract changes/ modifications

14. Contractor’s overall performance

15. Have there been any contract modifications or disputes/claims relative to the contract?

If “yes”, please explain in “Additional Remarks”.

Yes: ____ No:____

16. Has action been initiated to cancel or terminate contract for default?

If yes, please explain in “Additional Remarks”.

Yes: ___ No:_____

17. Given a choice, would you use this contractor again?

Yes: ____ No_____

Do you know anyone else who can tell us about this contractor’s performance? (Please list Name,Phone No. and Fax No.)

Name: ________________________________Phone: _______________Fax: ________________

Name: ________________________________Phone: _______________Fax: ________________

Name: ________________________________Phone: _______________Fax: ________________

Additional Remarks: (Use separate sheets as necessary)

Respondent Signature

Date

Please forward questionnaire to the Contracting Officer, Ms. Sheela Casper at sheela.casper@fletc.dhs.gov SOURCE SELECTION INFORMATION – See FAR 2.101 and FAR 3.104

PROCUREMENT SENSITIVE – FOR OFFICIAL USE ONLY