J7_Past Performance Questionnaire .docx

PAST PERFORMANCE QUESTIONNAIRE AND COVER LETTER

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

SUBJECT: Request for Past Performance Evaluation

TO:

You have been identified as a point of contact for a past performance evaluation of the firm listed on the attached questionnaire. This firm is currently being considered for an Industrial Heating and Water Cooling Treatment at Joint Base McGuire-Dix-Lakehurst, New Jersey (JBMDL, NJ) Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, please contact Jasmin Rankins at jasmin.rankins@us.af.mil.

1 Attachment Past and Present Performance Questionnaire

Section 1: Contract Identification A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

3. Reason for difference (if applicable):

I. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $

2. Current maximum contract dollar value (assuming all options exercised): $

3. Reasons for difference between original and current contract dollar value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? ☐ Yes ☐No

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel Note

If offeror holds or has held other contracts with your agency/organization in the last three

(3) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

Section 2: Customer or Agency Identification A. Customer or agency name:

B. Customer or agency description (if applicable):

For

Official

Use

Only When completed, this document is

Source

Selection

Information

IAW

FAR

2.101 and

3.104 J11_Past

Performance

Questionnaire C.

For

Official

Use

Only Page of

D. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands):

Section 3: Respondent Identification

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone number / e-mail address:

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

E. Other suggested points of contact:

Section 4: Performance Information In the tables below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

SUPPORTING INFORMATION:

2. Demonstrated the ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems. SUPPORTING INFORMATION:

5. Followed approved quality control plan. SUPPORTING INFORMATION:

6. Provided effective quality control and/or inspection procedures to meet contract requirements.

7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

SUPPORTING INFORMATION:

8. Provided timely resolution of contract discrepancies. SUPPORTING INFORMATION:

9. Identified problems as they occurred. SUPPORTING INFORMATION:

10. Suggested alternative approaches to problems. SUPPORTING INFORMATION:

11. Displayed initiative to solve problems. SUPPORTING INFORMATION:

12. Developed realistic progress schedules. SUPPORTING INFORMATION:

13. Met established project schedules. SUPPORTING INFORMATION:

14. Provided timely resolution of warranty defects. SUPPORTING INFORMATION:

15. Was responsive to contract changes. SUPPORTING INFORMATION:

16. Provided adequate project supervision.

17. Obtained consent of surety for increases in bonding as work-in-progress increased.

18. Paid subcontractors/suppliers in a timely manner. SUPPORTING INFORMATION:

19. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

20. Cooperated with Government personnel after award. SUPPORTING INFORMATION:

21. Met or exceeded small business and small disadvantaged business goals set forth in the approved subcontracting plan.

22. How would you rate the contractor's overall performance on this contract? SUPPORTING INFORMATION:

23. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.

EXPLANATION:

· Yes

· No

· No image1.png image2.png