PAST PERFORMANCE SURVEY.pdf
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- Solicitation number
- 697DCK-26-R-00404
About this file
This is a Past Performance Survey form used by the Federal Aviation Administration to evaluate contractor performance on a completed federal contract. The survey is for contract 697DCK-26-5-00404, a Chiller Repair Project located at 37075 Aviation Lane, Hilliard, Florida 32046. The survey must be completed and returned to Regina Singleton, Contracting Officer at regina.singleton@faa.gov within three days of receipt.
The survey requests basic contract information including contractor name, contract number, contract type (Firm Fixed Price, Cost Reimbursement, or Other), period of performance, dollar amount of award, contract title, and description of services. It then presents 19 scaled rating questions (1-5 scale, with 1 being Unsatisfactory and 5 being Outstanding) covering contractor performance areas such as resource commitment, responsiveness to technical direction, reliability on commitments, management visibility, responsiveness to requests, user requirement identification, contract administration ability, correspondence quality, Statement of Work adherence, staff satisfaction, report timeliness and accuracy, safety compliance, quality of service, government interface effectiveness, customer satisfaction, and employee qualifications. The form also includes yes/no questions regarding cure notices, contractor pro-activity, cost-saving suggestions, contractor recommendation, and federal-specific investigations (Labor Department, safety, security, and terminations). A final section requests narrative descriptions of any performance issues and general comments. The survey requires respondent signature and date.
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PAST PERFORMANCE SURVEY
697DCK-26- -00404
The Federal Aviation Administration is currently evaluating ____________________________ and you were listed you as a performance reference. It would be greatly appreciated if you would take 5 or 10 minutes to complete the following information and email the survey back to my attention within three (3) days of receipt to my attention at: regina.singleton@faa.gov
If you have any questions or comments, feel free to contact me via email. Thank you in advance for your assistance.
Regina Singleton, Contracting Officer Federal Aviation Administration Acquisition Branch, Routing Symbol AAQ-5A0 College Park, GA 30337 Tel: 404-305-5790
1. Contractor Name: 2. Contract Number:
3. Contractor Address: 4. Contract Type: __Firm Fixed Price ____Cost Reimbursement ___ Other (Please Specify)
5. Your Agency Name: 6. Your Agency POC/Phone/email/Fax:
7. Period of Performance: 8. Dollar Amount of Award: $ Total Dollar Value with Mods:
9. Title of Contract:
10. Description of Contract Service:
11. Type of Work:
Construction__ Service Support__ Service__ Supply__ Other___________________
NOTE: 1-Unsatisfactory 2- Marginal 3-Satisfactory 4-Good 5-Outstanding If Not Applicable, just write in N/A
Chiller Repair Project
37075 Aviation Lane Hilliard, FL 32046
To: _________________________ (Point of Contact) _________________________ (Company) _________________________ (Phone) _________________________ (Fax)
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Please provide additional comments below for ratings of 3 and below.
1. Did the contractor commit adequate resources in timely fashion to the contract to meet the requirements and to successfully solve problems? 1 2 3 4 5
2. To what extent did the contractor respond positively and promptly to technical direction, contract change orders, etc.? 1 2 3 4 5
3. How reliably did the contractor follow through on commitments?
1 2 3 4 5
4. To what extent did the contractor’s management system provide visibility into problems and risks?
1 2 3 4 5
5. How responsive do you think the contractor was to information requests, issues, or problems during the course of the contract? 1 2 3 4 5
6. How effective has the contractor been in identifying user requirements?
1 2 3 4 5
7. To what extent did the contractor have the ability to administer and manage the contract?
1 2 3 4 5
8. To what extent did the contractor issue professional correspondence?
1 2 3 4 5
9. How well did the contractor adhere to the Statement of Work? 1 2 3 4 5
10. What was your level of satisfaction with the contractor’s management and support staff?
1 2 3 4 5
11. What was your level of satisfaction with the contractor’s Supervisor(s)?
1 2 3 4 5
12. To what extent did the contractor submit required reports and documentation in a timely manner? 1 2 3 4 5
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13. To what extent were the contractor’s reports and documentation accurate and complete?
1 2 3 4 5
14. To what extent was the contractor’s maintenance and problem tracking/reporting documentation timely, accurate and of appropriate content?
1 2 3 4 5
15. To what extent did the contractor comply with safety requirements?
1 2 3 4 5
16. What was your level of satisfaction with the contractor’s overall quality of service?
1 2 3 4 5
17. To what extent was the contractor effective in interfacing with the Government staff? 1 2 3 4 5
18. What was your level of overall customer satisfaction? 1 2 3 4 5
19. To what extent were the contractor’s employees experienced and qualified?
1 2 3 4 5
Respond: Yes or No.
20. Were there any cure notices issued? Yes: ____ No: ____
21. Was contractor pro-active? Yes: ____ No: ____
22. Did contractor suggest cost-saving changes? Yes: ____ No: ____
23. Would you recommend this contractor? Yes: ____ No: ____ For Federal contracts:
24. Were there any Labor Department Investigations? Yes: ____ No: ____
24a. If yes, please describe reason and final outcome.
25. Were there any safety investigations? Yes: ____ No: ____
25a. If yes, please describe reason and final outcome.
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26. Were there any security investigations? Yes: ____ No: ____
26a. If yes, please describe reason and final outcome.
27. Was there a partial or complete termination for default or convenience?
Yes: ____ No: ____
27a. If yes, please describe reason and final outcome.
28. Are there any pending terminations? Yes: ____ No: ____
29. What is/was the duration of the contract? _____________________
30. Were there any performance issues regarding the contractor’s work? If yes, please describe.
Please provide other comments:
Signature: ____________________________
Date: ____________________________
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