DRAFT Past Performance Questionnaire 22 dec 08.pdf

RFP FA8224-09-R-0004

18 Dec 2008

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 309PK.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.

N NOT APPLICABLE - Unable to provide a score. Performance in this area is not applicable to effort assessed.

mailto:309PK.SourceSelection@hill.af.mil

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.

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 on-site supervision in areas such as administrative, technical, procurement, and logistical functions (e.g. material storage, transportation, special equipment, etc.).

E V S M U N P

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

E V S M U N P

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

E V S M U N P

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

E V S M U N P

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

E V S M U N 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 N P

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

E V S M U N 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).

(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 N P

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

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

General Questions

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

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

(n) 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.

(o) Is there anyone else we should 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