DRAFT Past Performance Questionnaire 15 April 2009.doc

RFP FA8224-09-R-0004

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NUMBER – FA8224-09-R-0004

1. Please complete this questionnaire. Handwritten responses are sufficient. If you need more space than provided, please attach additional pages or write on the back. Responses will be treated as source selection sensitive information. Please email the completed questionnaire to:

Source Selection Team

309mxw.pk.sourceselection@hill.af.mil

Reference Solicitation Nr: FA8224-09-R-0004 DSN phone: 586-3347

Commercial phone: (801) 586-3347

2. Explanation of codes:

CODE

PERFORMANCE LEVEL

E EXCEPTIONAL - Performance meets contractual requirements and exceeds many (requirements) to the Government's benefit. The contractual performance of the element 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 of the element 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 of the element 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 of the element 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 of the element being assessed contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

NA

NOT APPLICABLE – Contractor did not participate in this type of activity under this contract.

UTA

Unable To assess - The individual completing this questionnaire does not possess the background or knowledge to accurately answer. (e.g. Contracting Officer answering technical questions)

P Proprietary – The answer will lead to release of proprietary data and cannot be provided.

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

A. Contractor:

B. CAGE Code:

C. Contract number:

D: Order Number if applicable:

E. Period of Performance:

F. Negotiated price or cost at award:

G. Current estimated contract dollar amount:

H. Describe product service performed by contractor being evaluated.

4. Circle the appropriate letter for each item on the questionnaire. Please provide supporting narrative in the spaces provided.

ASSESSMENT ELEMENTS (If more space is needed, write on back or attach pages)

Task Order Management Plan

(a) Rate the contractor’s success in providing capable and responsive on-site supervision.

E V S M U

NA

UTA

P

(b) Rate the contractor’s ability to direct administrative, technical, procurement, and logistical functions.

E V S M U

NA

UTA

P

(c) Rate the contractor’s success in performing within budget and schedule.

E V S M U

NA

UTA

P

(d) Rate the contractor’s success in responding to emergency or problematic situations.

E V S M U

NA

UTA

P

(e) Rate the contractor’s success in providing qualified personnel.

E V S M U

NA

UTA

P

(f) Rate the contractor’s success in responding to schedule changes (e.g. extra shifts, swing, graveyard, weekend, holiday, etc.).

E V S M U

NA

UTA

P

(g) Rate the contractor’s success in communicating project status (e.g. issues, delays, etc.).

E V S M U

NA

UTA

P

Quality & Safety Plan

(h) Rate the contractor’s success in maintaining a clean and safe working environment, including tool and Foreign Object Damage (FOD) control (if applicable).

E V S M U

NA

UTA

P

(i) Rate the contractor’s success in providing quality products/services. Equipment and machinery that is removed, relocated, modified, and installed performs to manufacturer’s or customer’s specifications, including professional appearance of finished work.

E V S M U

NA

UTA

P

(j) Rate the contractor’s success in correcting quality deficiencies in a timely manner.

E V S M U

NA

UTA

P

(k) Rate the contractor’s success in following safety guidelines and regulations.

E V S M U

NA

UTA

P

Contractor Work

(l) Rate the contractor’s success in removing, relocating, and installing equipment and machinery.

E V S M U

NA

UTA

P

(m) Rate the contractor’s success in repair, modification, and maintenance of equipment and machinery.

E V S M U

NA

UTA

P

(n) Rate the contractor’s success in job site refurbishment services necessary to accommodate the relocation or installation of equipment and machinery.

E V S M U

NA

UTA

P

(o) Rate the contractor’s success in complying with national, state, local, and other applicable regulations and codes for mechanical work, fire protection, safety, health, environmental protection.

E V S M U

NA

UTA

P

(p) Rate the contractor’s success in modifying electrical, mechanical, HVAC, plumbing, pneumatic, and any other associated and connected systems.

E V S M U

NA

UTA

P

General Questions

(q) What is your overall rating of the contractor’s performance?

E V S M U

NA

UTA

P

(r) Given the choice, would you award to this contractor again?

(s) Are you aware of any other contracted efforts performed by this contractor similar in nature to this contract? Please identify contract/program and point of contact.

(t) Is there anyone else we can send this questionnaire to? Please identify by name, organization, and phone number.

5. Please provide the name, title, address, phone number, and email address of the person completing this questionnaire Phone:

Email:

6. Thank you for your assistance in this source selection. If you have any questions, please call the Government Contracting Officer: Preston Davis at (801) 586-3347.

15 April 2009