Attachment_2_Past_Performance_Questionnaire.pdf

W9124J-12-R-0014 Attachment 2

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

SECTION 1: CONTRACT IDENTIFICATION

Contractor:

Cage Code:

Contract number:

Contract type:

Was this a competitive contract? Yes _____ No _____ Role: Prime Contractor ______ or Sub-Contractor _____ Period of performance:

Initial contract cost: $ Current/final contract cost: $ Reasons for differences between initial contract cost and final contract costs:

Description of construction services provided:

SECTION 2: CUSTOMER OR AGENCY / EVALUATOR IDENTIFICATION

Customer or agency name:

Customer or agency description (if applicable):

Evaluator's name:

Evaluator's title (COR, Contracting Officer, etc):

Evaluator's phone number and email address:

Number of years evaluator worked on subject contract:

SECTION 3: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE LEVEL

S SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained 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 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.

US UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE - Unable to provide a rating.

QUALITY: S M US N/A

Contractor provided effective quality control and/or inspection procedures to meet contract requirements.

Contractor provided well researched and clearly identified submittals that matched contract requirements.

Contractor completed all work with good workmanship and in conformance with the specifications.

Contractor corrected deficiencies in a timely manner and pursuant to their quality control plan.

TIMELINESS: S M US N/A

Contractor met established project schedules to complete the project on time.

Contractor provided timely cost/design proposals.

Contractor submitted the progress schedule and progress reports as required.

Contractor provided on-time submittals as required.

Contractor provided payrolls for both their employees and their subcontractors employees as required.

Contractor provided timely resolution of all punch list items.

RESPONSIVENESS: S M US N/A

Contractor acted promptly to resolve problems, ensuring compliance with contract requirements and safety regulations.

Contractor was reasonable and cooperated to resolve problems, attended meetings as needed, and maintained communication with the government to keep the project on schedule or minimize the delay.

Contractor identified problems as the occurred, suggested approaches to the problems, and displayed initiative to solve problems.

Contractor responded to warranty issues within the time frames specified in the contract.

SUBCONTRACTS AND MANAGEMENT: S M US N/A

Contractor provided experienced/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

Contractor hired quality subcontractors and effectively managed and coordinated their work.

Contractor hired, maintained, and replaced as necessary, qualified personnel and subcontractors/suppliers.

Contractor ensured the project manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule.

Contractor ensured site superintendent and quality control representative were consistently present on site when work was performed.

Contractor paid employees/subcontractors/suppliers as required.

CHANGE/COST CONTROL: S M US N/A

Contractor responsive to contract changes and provided accurate, reasonable and supportable cost proposals.

Contractor demonstrated the ability to control costs and/or design projects or modifications within the magnitude specified.

Contractor validated subcontractor cost proposals prior to submission to the Government.

SECTION 4: NARRATIVE SUMMARY

1. Please discuss each and every response for which you indicated M (Marginal) or US (Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

2. Please provide any additional comment concerning the contractor’s performance, as desired.

3. GOVERNMENT CONTRACTS ONLY: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?

- If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc.)

4. GOVERNMENT CONTRACTS ONLY: Was the contractor ever issued a cure or show cause notice under the referenced contract?

- If yes, explain outcome in “Remarks”.

5. Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding projects?

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address:

Mission and Installation Contracting Command – FSH ATTN: Kimberly Miller, Contract Specialist 2205 Infantry Post Road, BLDG 604 Fort Sam Houston, TX 78234

Email Address:

kimberly.miller19@us.army.mil and latischa.r.castro.civ@mail.mil mailto:kimberly.miller19@us.army.mil mailto:latischa.r.castro.civ@mail.mil