Questionnaire.pdf

Federal Aviation Administration

PAST PERFORMANCE QUESTIONNAIRE

The Federal Aviation Administration (FAA), EnRoute and Terminal Facilities Programs currently have a requirement to modernize a building recently acquired by the FAA at 3721 Macintosh Drive, Warrenton, VA. The company listed below has selected your project as a reference to meet the past performance requirement.

CONTRACTOR NAME: ___________________________________________

TO: Government agency or commercial organization (i.e., customer) with knowledge on offeror's past performance.

Please complete this questionnaire, which concerns the past performance of a contractor who is doing business (or has done business) with you, and is interested in doing business with the Federal Avaition Administration. Email the completed questionnaire to the attention of Susan.Newcomb@faa.gov; Your completed questionnaire must be provided directly to the FAA Contracting Officer from you. FAA will not accept completed questionnaires sent from the offeror. Handwritten responses are sufficient. If you need more space than that provided, please attach additional pages. Responses will be treated as source selection sensitive information.

FAA SIR Number:

*ATTN: Contracting Officer:

( ) *email

@FAA.GOV

2. Please complete the following identifying information and past performance assessment:

A. Contractor:

B. Contract Number:

C. Period of Performance:

D. Total Contract Amount (Including any Options) E. Describe product acquired:

697DCK-22-R-00366

Susan Newcomb , 718-238-7659

Susan.Newcomb

PLEASE RESPOND TO THE FOLLOWING:

NOTE :

1-Unsatisfactory 2-Marginal 3-Satisfactory 4-Good 5-Outstanding NA-Not Applicable Please provide additional comments for ratings of 3 and below.

1. How well did the contractor adhere to the Statement of Work?

1 2 3 4 5 NA

2. How well did the contractor maintain an effective quality control program?

3. Did the contractor provided a product or service that conformed to standards of good workmanship?

4. To what extent were the contractor’s reports and documentation accurate and complete?

5. To what extent did the contractor respond positively and promptly to technical direction, contract change orders, etc.?

6. Did the contractor commit adequate resources in a timely fashion to the contract to meet the requirements and to successfully solve problems?

7. How well did the contractor comply with the contract time of performance and critical schedule milestones?

8. To what extent did the contractor submit required reports and documentation in a timely manner?

9. How reliably did the contractor follow through on commitments?

10. To what extent did the contractor’s management system provide visibility into problems and risks?

11. How responsive do you think the contractor was to information requests, issues, or problems during the course of the contract?

12. Were contract changes reasonably negotiated?

13. To what extent did the contractor have the ability to administer and manage the contract?

14. Effectiveness of on-site management, including management of subcontractors, suppliers, materials and/or labor force?

15. How well the contractor coordinated work between different trades?

16. To what extent were the contractor’s employees experienced and qualified?

17. How well did the contractor manager long lead material procurement and delivery?

18. To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues?

19. What was your level of satisfaction with the contractor’s overall quality of service?

20. To what extent was the contractor effective in interfacing with the Owner’s staff?

21. What was your level of overall customer satisfaction?

22. To what extent were the contractor’s employees experienced and qualified?

NOTE:

Respond Yes or No

23. Were there any cure notices issued?

Yes No

24. Was contractor pro-active?

25. Did contractor suggest cost-saving changes?

26. Would you recommend this contractor?

NOTE:

For Federal Contracts ONLY.

27. Were there any Labor Department Investigations?

27a. If yes, please describe reason and final outcome.

28. Were there any safety investigations?

28a. If yes, please describe reason and final outcome.

29. Were there any security investigations?

29.a. If yes, please describe reason and final outcome.

30. Was there a partial or complete termination for default or convenience?

30.a. If yes, please describe reason and final outcome.

31. Are there any pending terminations?

32. What is/was the duration of the contract?

33. Were there any performance issues regarding the contractor’s work?

33.a. If yes, please describe reason and final outcome.

34. Please provide other comments:

Signature: Date: