Attachment_11_-_Past_Performance_Questionnaire.pdf

Solicitation No.: FA446019RA004

Attachment 11

Past Performance Questionnaire

The 19th Contracting Squadron of the Air Force Air Mobility Command is in the process of competitively selecting a source for a construction program. This requirement is for the Airfield Pavements IDIQ contract, Little Rock Air Force Base, Arkansas. The contractor is required to provide all services necessary for the completion of the projects.

One of the considerations in proposal evaluation is the verification of the offerors' past performance on contracts or other work efforts which reflect the offeror's ability to perform on the proposed effort. We depend on information received from organizations such as yours, which have had first-hand experience with the offeror, for the evaluation of the offeror's performance on those contracts or work efforts.

Our areas of interest regarding the offeror are summarized in the enclosed questionnaire. In order to meet the acquisition milestones, we request your written response no later than 29 March 2019 @ 1:00PM LOCAL (CST). This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out electronically and e-mailed to christopher.arnold.19@us.af.mil and rachel.italiano.1@us.af.mil. Your completed questionnaire will become a part of the official source selection records.

Your assistance is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

Signature Jesse L. Christy Contracting Officer

Atch Past Performance Questionnaire

CHRISTY.JESS

E.L.1075995322

Digitally signed by

CHRISTY.JESSE.L.1075995322

Date: 2019.03.07 15:35:25 -06'00'

Past Performance Questionnaire

MEMORANDUM FOR (Contractor please add reference information)

FROM: 19 CONS/PKA

642 THOMAS AVENUE

LITTLE ROCK ARB AR 72099-4971

SUBJECT: Request for Past Performance Questionnaire Information for FA4460-19-R-A004 Little Rock Air Force Base Airfield Pavements IDIQ.

1. You have been identified as a reference point of contact for past and/or present performance evaluation of the firm listed on the attached questionnaire form. This firm is currently interested in providing a proposal for the above reference project.

2. Please complete the attached survey questionnaire. You should e-mail the survey back to 2Lt Christopher Arnold at christopher.arnold.19@us.af.mil. Also send a copy to Rachel L. Italiano at rachel.italiano.1@us.af.mil. If you have any questions, please contact 2Lt Christopher Arnold at

(501) 987-2058 or Rachel L. Italiano at (501) 987-3853. Your information MUST be submitted by 29 March 2019 @ 1:00PM LOCAL (CST). Your expedient attention regarding this matter is greatly appreciated. Thank you in advance.

JESSE L. CHRISTY

Contracting Officer

Attch Past Performance Questionnaire

CHRISTY.JESS

E.L.1075995322

Digitally signed by

CHRISTY.JESSE.L.1075995322

Date: 2019.03.07 15:46:42 -06'00'

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: Please correct any information below known to be inaccurate:

Contractor’s Name: _______________________________ Telephone Number: ______________________________ Fax Number: ____________________________________ Point of Contact: _________________________________ Project Title: ___________________________________________________________________ Description of Work: ___________________________________________________________*

Contract Number: ______________________ Dollar Amount: _________________________* Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.): ____________________________________ Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 5 years, please complete separate evaluation forms for those contracts as well.

Contract Period of Performance:

1. Original Schedule (assuming all options exercised):

Beginning Date ______________ through ________________

2. Current Schedule (assuming all options exercised):

Beginning Date ______________ through _________________

3. Reason for difference (if applicable):

B. RESPONDENT INFORMATION:

Customer or Agency Name: ____________________________ Name of Respondent: _________________________________ Title: ______________________________________________ Telephone Number: __________________________________ Fax Number: _______________________________________ Email Address: ______________________________________

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

C. EMAIL COMPLETED SURVEY FORM TO: 2Lt Christopher Arnold at christopher.arnold.19@us.af.mil and Rachel Italiano at rachel.italiano.1@us.af.mil.

D. PERFORMANCE INFORMATION: In the table 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:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

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.

The Contractor: E V S M U N/A

1. Followed all Airfield Regulations (i.e. speed limits, off limits areas etc.).

SUPPORTING INFORMATION:

2. Properly demonstrated the ability to communicate with the tower when needed (i.e. operation of a land moblie radio, knows when the tower needs to be contacted etc.).

SUPPORTING INFORMATION:

3. Demonstrated the ability to work on an airfield while the remaining area of the airfield is still operational.

SUPPORTING INFORMATION:

4. Demonstrated ability to set up safe airfield construction zones and maintain safety controls throughout the project duration including moving to separate phases.

SUPPORTING INFORMATION:

5. Demonstrated the ability to submit all required submittals throughout the duration of the contract.

SUPPORTING INFORMATION:

6. Demonstrated the ability to set up and maintain Storm Water Pollution Prevention measures during construction.

SUPPORTING INFORMATION:

7. Demonstrated the ability to submit accurate As-Built and/or GIS data, SDSFIE compliant, post construction.

SUPPORTING INFORMATION:

8. Demonstrated ability to perform airfield rubber removal & friction testing on concrete & asphalt pavements by the chemical detergent method.

The Contractor: E V S M U N/A

SUPPORTING INFORMATION:

9. Demonstrated ability to complete demolition work on airfield concrete pavements without damaging surrounding concrete to remain.

SUPPORTING INFORMATION:

10. Demonstrated the ability to complete partial depth airfield spall repairs on concrete.

SUPPORTING INFORMATION:

11. Demonstrated the ability to complete full depth airfield concrete repairs.

SUPPORTING INFORMATION:

12. Demonstrated the ability to successfully place concrete in adverse conditions to include cold temperatures, hot temperatures and/or windy conditions.

SUPPORTING INFORMATION:

13. Demonstrated cooperativeness to replace or correct failed areas of work such as cracked concrete.

SUPPORTING INFORMATION:

14. Demonstrated the ability to finish airfield concrete.

SUPPORTING INFORMATION:

15. Demonstrated ability to properly saw cut airfield concrete.

SUPPORTING INFORMATION:

16. Demonstrated the ability to meet pavement smoothness and grade control requirements on new and repair construction projects.

The Contractor: E V S M U N/A

SUPPORTING INFORMATION:

17. Demonstrated the ability to meet subgrade and base course compaction requirements.

SUPPORTING INFORMATION:

18. Demonstrated the ability to meet asphalt compaction, grade, and thickness requirements.

SUPPORTING INFORMATION:

19. Demonstrated concrete quality control measures on all airfield concrete placements.

SUPPORTING INFORMATION:

20. Demonstrated ability to install aircraft tiedowns and grounding rods in new and existing pavements.

SUPPORTING INFORMATION:

21. Demonstrated the ability to establish sod or hydro-seed post construction.

SUPPORTING INFORMATION:

22. Demonstrated the ability to meet airfield drainage requirements by grading and piping.

SUPPORTING INFORMATION:

23. Demonstrated the ability to layout and paint new airfield markings.

SUPPORTING INFORMATION:

24. Demonstrated ability to eradicate airfield markings without damaging the pavement surface or joints.

The Contractor: E V S M U N/A

SUPPORTING INFORMATION:

25. Demonstrated ability to accurately keep installed quantities and submit for payment quantities on a line item contract.

SUPPORTING INFORMATION:

26. Demonstrated flexibility and cooperativeness with scheduling work with respect to security requirements, airfield operations, military contingencies & exercises, DV visits, Air Shows, coordination with other ongoing airfield projects, and coordination with all project stakeholders.

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

30. Home office participated in solving significant local problems.

SUPPORTING INFORMATION:

31. Followed approved quality control plan.

SUPPORTING INFORMATION:

The Contractor: E V S M U N/A

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

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

34. Provided timely resolution of contract discrepancies.

SUPPORTING INFORMATION:

35. Identified problems as they occurred.

SUPPORTING INFORMATION:

36. Suggested alternative approaches to problems.

SUPPORTING INFORMATION:

37. Displayed initiative to solve problems.

SUPPORTING INFORMATION:

38. Developed realistic progress schedules.

SUPPORTING INFORMATION:

39. Met established project schedules.

SUPPORTING INFORMATION:

40. Provided timely resolution of warranty defects.

SUPPORTING INFORMATION:

41. Was responsive to contract changes.

The Contractor: E V S M U N/A

SUPPORTING INFORMATION:

42. Provided adequate project supervision.

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

44. Paid subcontractors/suppliers in a timely manner.

SUPPORTING INFORMATION:

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

SUPPORTING INFORMATION:

46. Cooperated with Government personnel after award.

SUPPORTING INFORMATION:

47. How would you rate the contractor's overall performance?

SUPPORTING INFORMATION:

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

EXPLANATION:

☐ Yes

☐ No

49. Would you award another contract to this contractor? If not, explain.

EXPLANATION: ☐ Yes

☐ No

The Contractor: E V S M U N/A

50. Is the contractor rated in CPARS? ☐ Yes

☐ No

Additional Remarks:

Respondent’s Signature Date

Thank you for your prompt response and assistance!