J.26 Past Performance Questionnaire 5-31-24.docx

OFFEROR INFORMATION

Company Name:

Point of Contact (POC):

POC Title:

POC Telephone No.:

POC E-Mail:

For each project included in the technical proposal, an associated past performance questionnaire must be provided.

In accordance with L.4.1.2, failure to copy both the CS and no questionnaires are returned by the customer, then the offeror may receive an Unknown Confidence rating.

If you are utilizing the FAA for this past performance questionnaire, please direct it to the FAA Project Execution Lead (PEL) or Contracting Officer’s Representative (COR) for each respective project.

Project Name:

Contract Number:

Task Order Award Number (if applicable):

Contract Type (FFP, Cost Reimbursable, etc.):

Project/Task Order Period of Performance:

Approximate Project/Task Order Dollar Value:

Contract or Project/Task Order Description:

We are currently responding to the Federal Aviation Administration’s (FAA) Screening Information Request (SIR) No. [TBD], for Critical Power Systems (CPS). The FAA places emphasis in an Offeror’s past performance and experience as an evaluation factor in its procurements. Accordingly, the FAA is requiring that customers of Offerors responding to the SIR be identified and their participation in the evaluation process be requested.

We have identified Mr./Ms. [Insert name of Customer] of [Insert name of Customer’s company] as the point of contact based on his/her knowledge concerning our work. Your cooperation and completion of the following Past Performance Questionnaire is appreciated. If contacted by a representative of the FAA requesting additional information and/or clarification of your response to the questionnaire, you are hereby authorized to respond to such a request.

ATTACHMENT J.26

PAST PERFORMANCE QUESTIONNAIRE

PART ONE: INSTRUCTIONS

The company who provided this questionnaire is proposing on a Federal Aviation Administration (FAA) Critical Power Systems (CPS) Installation and Design Contract. Past performance is of considerable importance to this Source Selection. Therefore, input from current or previous customers of the Contractor is very important.

We would greatly appreciate you taking the time to complete this form. Please provide an honest assessment and immediately return no later than (Insert date provided by CS] the following point of contact:

Stefanie Wiles and Amanda Garen, Contract Specialists (AAQ-720) E-mail: Stefanie.Wiles@faa.gov and Amanda.J.Garen@faa.gov Subject Line: SIR # Offeror Name – Past Performance

If you have any questions, please contact Stefanie Wiles and Amanda Garen via email, provided above.

GENERAL INFORMATION

1. Please complete this questionnaire indicating the Contractor’s performance for the identified program based on the ratings listed under PART 2. Assessments should reflect only performance for which the Contractor is/was responsible.

2. Please select a “Number” or “Yes” / “No” corresponding to your rating or “N/A” if you are unable to provide a rating for an area. Selecting N/A is not detrimental to overall score of the Contractor.

3. You are urged to supplement your own knowledge of the Contractor’s performance with judgment of others in your organization. In addition to completing the attached questionnaire for the identified project/program, we solicit your comments on other similar projects/programs for which your activity has contracts with this Contractor.

4. Please return completed questionnaire(s) to both Contract Specialists, by e-mail, no later than [(Insert date provided by CS] to the following:

Stefanie Wiles and Amanda Garen, Contract Specialists (AAQ-720) E-mail: Stefanie.Wiles@faa.gov and Amanda.J.Garen@faa.gov

ATTACHMENT J.26

PAST PERFORMANCE QUESTIONNAIRE

Please indicate if performance involved one or more of the following products or services by marking all that apply:

Program Management: ☐ Design Services:

Engine Generator(s) ☐ Uninterruptible Power System(s) ☐ Fuel Storage Tank(s)☐

Installation Services:

Engine Generator(s) ☐ Uninterruptible Power System(s) ☐ Fuel Storage Tank(s) ☐

Other:

PART TWO: QUESTIONS

All questions must have a response. If the question does not apply please select N/A.

The numbers 0 to 4 correspond with the following descriptive values provided on the questionnaire below:

PROCUREMENT SENSITIVE WHEN COMPLETED FOR OFFICIAL USE ONLY

A. PROGRAM MANAGEMENT

trained and skilled personnel, in a timely manner, to manage this program?

N/A

a task or project?

N/A

ability to quickly identify technical, management or schedule problems and provide venues to resolve them?

N/A

program?

N/A

delivery schedules?

N/A

reports?

N/A

and Alternate Program Manager?

N/A

Government/Customer personnel?

N/A

Government/Customer personnel?

N/A

Government/Customer personnel?

N/A

of this contract?

N/A

rescheduled as a result of the Contractor’s inability to perform?

a. If so, for what?

b. What action did the Contractor take to correct the situation?

Yes☐ or No ☐

If so, why?

Yes ☐ or No ☐ or N/A☐

B. DESIGN SERVICES

Services?

N/A

N/A

N/A

N/A

N/A

accurate?

N/A

N/A

N/A

C. INSTALLATION SERVICES

Services?

N/A

project with their work schedule?

N/A

tracking equipment shipments and arranging delivery?

N/A

coordinating permits and approvals from Federal, State and local authorities having jurisdiction over the projects Scope- of-Work?

N/A

obtaining qualified subcontractors, such as licensed electricians and fuel tank installers?

N/A

completing as-built drawings?

N/A

resolving the final inspection discrepancy list?

N/A

schedule overall?

N/A

performance for this installation contract?

N/A

D. Would you recommend award of a similar contract to this contractor? Yes ☐ or No ☐

PART THREE: CUSTOMER INFORMATION

The following information will assist in the analysis of the data provided. Information will be kept CONFIDENTIAL:

Name of Respondent:

Position Title:

Organization:

Telephone No.:

Length of Involvement in Program/Contract:

Date Questionnaire Completed: