PAST PERFORMANCE QUESTIONNAIRE.docx

FA2550-10-R-1001

Attachment #4

PAST PERFORMANCE QUESTIONNAIRE

I. Evaluation of Offeror:

Company/Division Providing Services: ___________________________________ Address: ___________________________________________________________________ POC Name: ________________________________________Phone: __________________ Description of Services Provided: _______________________________________________

II. Contract Information:

Contract Number: __________________ Dollar Value (Annual): ______________ Performance Period: ________________ Performance Location: ______________ Type of Contract: __________________

Check One:

Fixed Price ______ Cost Reimbursement ______ Other (Please Specify) _______

Check One:

Negotiated ______ Sealed Bid ______Competitive ______Non-Competitive _________ Basis of Payment:

Commodity ______ Labor/Equipment Hours ______ other (specify) ______________ Type & Extent of Subcontracting: ________________________________________________

III. Evaluated by:

Company/Organization/Address: _________________________________________________ Name & Title: ________________________________________________________________ Signature: ______________________________________ Date: _______________________ Telephone: _________________________

FAX: ____________________________

IV. Evaluation:

Please answer questions 1 through 15 using the following criteria. Circle only one response per question.

For elements rated "unsatisfactory", please comment on the specific problem(s) or performance failure(s) that prompted this rating.

4 - Exceptional: Performance met and exceeded many of the contractual requirements to the organization's benefit. The contractual performance of the element being evaluated was accomplished with few minor problems for which corrective actions were highly effective.

3 - Very Good: Performance met and exceeded some to the contractual requirements to the organization's benefit. The contractual performance of the element being evaluated was accomplished with some minor problems for which corrective actions were effective.

2 - Satisfactory: Performance met contractual requirements. The contractual performance of the element being evaluated was accomplished with some minor problems for which corrective actions were satisfactory.

1 – Marginal: Performance barely met contractual requirements. The contractual performance of the element being evaluated reflects a serious problem for which corrective actions have not yet been identified, appear only marginally effective or were not fully implemented.

0 – Unsatisfactory: Performance did not meet some contractual requirement and recovery is not likely in a timely manner. The contractual performance of the element being evaluated reflects serious problems for which corrective actions were ineffective.

N/A: Not Applicable or not observed.

1. Evaluate the contractor's overall commitment to quality performance and customer satisfaction in power generation plant projects and in a high security environment.

Circle One: 4 3 2 1 0 N/A

Comment:

2. Evaluate the contractor's overall technical competence with emphasis on large scale multi-ton industrial moving operations and large generator placement and commissioning.

Circle One: 4 3 2 1 0 N/A

Comment:

3. Evaluate the contractor's cooperation and willingness to work as a team (with your personnel, subcontractors, other contractors, etc.).

Circle One: 4 3 2 1 0 N/A

Comment:

4. Evaluate the contractor's compliance with contractual requirements (i.e. were there any defaults or serious issues with previous contracts).

Comment:

5. Evaluate the contractor's responsiveness to contract, program and/or schedule changes with emphasis on delays caused by non-responsiveness to change orders causing scheduling delays.

Circle One: 4 3 2 1 0 N/A

Comment:

6. Evaluate the effectiveness of the contractor's overall quality control procedures.

Circle One: 4 3 2 1 0 N/A

Comment:

7. Evaluate the effectiveness of the contractor's safety program or efforts with emphasis on any safety issues that have occurred at power generator plants or at government facilities

Circle One: 4 3 2 1 0 N/A

Comment:

8. Evaluate the effectiveness of the contractor's on-site management and supervision with emphasis on experience in related areas.

Circle One: 4 3 2 1 0 N/A

Comment:

9. Evaluate the contractor's ability to overcome technical problems, labor issues, and/or other performance difficulties.

Circle One: 4 3 2 1 0 N/A

Comment:

10. Evaluate the contractor's ability to plan and conduct operations in the most cost effective manner.

Circle One: 4 3 2 1 0 N/A

Comment:

11. Evaluate the contractor's ability to adhere to schedules and complete work on time with emphasis on ability to minimizing downtime and working in high security environment.

Circle One: 4 3 2 1 0 N/A

Comment:

12. Evaluate the quality and stability of the contractor's workforce.

Circle One: 4 3 2 1 0 N/A

Comment:

13. Evaluate the availability, adequacy and suitability of the contractor's staffing for the work required with emphasis on having adequate quantities of experienced personnel versed in large scale multi-ton industrial moving operations and large generator placement and commissioning.

Circle One: 4 3 2 1 0 N/A

Comment:

14. Evaluate the availability, adequacy and suitability of the contractor's gear and equipment for the work required. This contract will require a large variety of equipment and equipment operational skills to fulfill the four major functional areas: removal of generators, installation of new generators, reprogramming controls and electrical and mechanical support work. Contractor must fulfill all equipment and equipment operational needs for all of these areas.

Comment: