J.26 Past Performance Questionnaire.pdf

ATTACHMENT J.26

PAST PERFORMANCE QUESTIONNAIRE

OFFEROR INFORMATION

Company Name:

Point of Contact (POC):

POC Title:

POC Telephone No.:

POC E-Mail:

Offeror must fill out the respective category, program and contract fields below in which the Offeror is submitting a technical proposal. In accordance with L.12.3, the Offeror will be considered non-responsive if the CO is not copied when the past performance questionnaire is sent to the customer.

Category: Category 1☐ Category 2☐ Category 3☐ Program: UPS☐ EG☐ FST☐ ELD☐ CPDS☐ 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. [6973GH-21-R-00088], for Power Systems Installation and Design Services. 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) Power Systems 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 CO] the following point of contact:

Stefanie Wiles, Contracting Officer (AAQ-722) E-mail: Stefanie.Wiles@faa.gov Subject Line: 6973GH-21-R-00088 Offeror Name Phase 2 – Past Performance Category #

If you have any questions, please contact Stefanie Wiles via email Stefanie.Wiles@faa.gov

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, by e-mail, no later than [(Insert date provided by CO] to the following:

Stefanie Wiles, Contracting Officer (AAQ-722) E-mail: stefanie.wiles@faa.gov mailto:Stefanie.Wiles@faa.gov mailto:Stefanie.Wiles@faa.gov

PROCUREMENT SENSITIVE WHEN COMPLETED

FOR OFFICIAL USE ONLY

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:

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 Supply(s) ☐ Electrical Distribution Equipment ☐ Fuel Storage Tank(s)☐ Underground Power Cable Distribution System☐

Installation Services:

Engine Generator(s) ☐ Uninterruptible Power Supply(s) ☐ Electrical Distribution Equipment ☐ Fuel Storage Tank(s) ☐ Underground Power Cable Distribution System☐

Other:___________________________________________

RATING PERFORMANCE LEVEL

3 EXCELLENT: Performance meets contractual requirements and exceeds many requirements to the benefit of the Government/Customer. The contractual performance of the factors being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective.

2 VERY GOOD: Performance meets contractual requirements and exceeds some requirements to the benefit of the Government/Customer. The contractual performance of the factors being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor were effective.

1 SATISFACTORY: Performance meets contractual requirements. The contractual performance of the factors contains some minor problems for which corrective actions taken by the Contractor appear or were satisfactory.

0 UNSATISFACTORY: Performance does not meet most contractual requirements and corrections are not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the Contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE: Performance does not apply to a particular case in question or is not available. Selecting N/A is not detrimental to overall score of the Contractor.

A. PROGRAM MANAGEMENT

1. How successful was the Contractor in providing fully trained and skilled personnel, in a timely manner, to manage this program?

N/A

2. How effective was the Contractor in managing all phases of a task or project?

N/A

3. How well did the Contractor demonstrate initiative and ability to quickly identify technical, management or schedule problems and provide venues to resolve them?

N/A

4. How effective was the Contractor’s quality control program?

N/A

5. How responsive was the Contractor in meeting equipment delivery schedules?

N/A

6. How timely was the Contractor in submitting required data reports?

N/A

7. How competent were key personnel, i.e., Program Manager and Alternate Program Manager?

N/A

8. How well did key personnel communicate with Government/Customer personnel?

N/A

9. How cooperative were key personnel with Government/Customer personnel?

N/A

10. How supportive was corporate management to the Government/Customer personnel?

N/A

11. How would you rate the Contractor’s overall management of this contract?

N/A

12. Have any major contract requirements been terminated or rescheduled as a result of the Contractor’s inability to perform?

a. If so, please explain?

Yes ☐ or No ☐

13. Were any “cure” or “show cause” notices issued?

a. If so, for what?

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

Yes☐ or No ☐

14. Was an election made not to exercise an option due to the Contractor’s poor performance?

If so, why?

Yes ☐ or No ☐ or N/A☐

B. DESIGN SERVICES

15. How effective was the Contractor in providing Engineering

Services?

N/A

16. How efficiently did the Contractor integrate your project design work with their work schedule?

N/A

17. How detailed was the contractor’s Site Survey and Report? 0

N/A

18. If the contractor provided a Statement-of Work, did the Contractor uphold the duties as outlined?

N/A

19. Was the Cost Estimate organized and structured in a way that pricing could be analyzed and all costs accounted for?

N/A

20. If the Contractor provide an Arc Flash Risk Assessment Report, was the Contractor’s assessment thorough and accurate?

N/A

21. How detailed were the drawings in the Engineering Package for this project?

N/A

22. How would you rate the Contractor’s overall performance providing Engineering Services?

N/A

C. INSTALLATION SERVICES

23. How effective was the Contractor in providing Installation

Services?

N/A

24. How efficiently did the Contractor integrate your installation project with their work schedule?

N/A

25. How would you rate the Contractor’s performance in tracking equipment shipments and arranging delivery?

N/A

26. How would you rate the Contractor’s performance in coordinating permits and approvals from Federal, State and local authorities having jurisdiction over the projects Scope-of-Work?

N/A

27. How would you rate the Contractor’s performance in obtaining qualified subcontractors, such as licensed electricians and fuel tank installers?

N/A

28. How would you rate the Contractor’s performance in completing as-built drawings?

N/A

29. How would you rate the Contractor’s performance in resolving the final inspection discrepancy list?

N/A

30. How well did the Contractor manage the installation project schedule overall?

N/A

31. How would you rate the Contractor’s overall technical 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: