Attachment 3 Past Performance Questionaire.pdf

SAMPLE TRANSMITTAL LETTER AND

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

26 January 2017

Your Company Letterhead

Date: _________________

To: ______________________________________

We have listed your firm as a reference for the work we have performed for you as listed below.

Our firm has submitted a proposal under a project advertised by the 134TH Air Refueling Wing

Contracting Office. In accordance with Federal Acquisition Regulations, they will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306 (e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please send your completed questionnaire to the following email address to arrive NOT LATER

THAN 15 March 2017. Do not return them to our company.

Richard.m.lusby.mil@mail.mil

If you have questions regarding the attached questionnaire, or require assistance, please contact

CMSgt Richard Lusby, 865-336-3353, richard.m.lusby.mil@mail.mil. Thank you for your assistance. E-Mail is preferred.

Signature and Title mailto:Richard.m.lusby.mil@mail.mil mailto:richard.m.lusby.mil@mail.mil

SOURCE SELECTION SENSITIVE WHEN COMPLETED*****NOT TO BE RELEASED OUTSIDE

GOVERNMENT CHANNELS***** RETURN THIS PAGE WITH QUESTIONNAIRE

RATING DESCRIPTIONS: Use the following descriptions as guidance in providing ratings.

RATING DEFINITION

Outstanding O) Proposal indicates an exceptional approach and understanding of the requirements and contains multiple strengths, and risk of unsuccessful performance is low. Proposal may contain weakness(es) which have little potential to cause disruption of schedule or degradation of performance.

Normal contractor effort and normal Government monitoring will likely be able to overcome any difficulties.

Good (G) Proposal indicates a thorough approach and understanding of the requirements and contains at least one strength, and risk of unsuccessful performance is low to moderate. Proposal may contain weakness(es) which have little potential to cause disruption of schedule or degradation of performance and normal contractor effort and normal Government monitoring will likely be able to overcome any difficulties, or the proposal contains a significant weakness or combination of weaknesses which may potentially cause disruption of schedule or degradation of performance and special contractor emphasis and close Government monitoring will likely be able to overcome difficulties.

Acceptable (A) Proposal meets requirements and indicates an adequate approach and understanding of the requirements, and risk of unsuccessful performance is no worse than moderate. Proposal contains a significant weakness or combination of weaknesses which may potentially cause disruption of schedule or degradation of performance. Special contractor emphasis and close Government monitoring will likely be able to overcome difficulties.

Marginal (M) Proposal has not demonstrated an adequate approach and understanding of the requirements, and/or risk of unsuccessful performance is high. Proposal contains a significant weakness or combination of weaknesses which is likely to cause significant disruption of schedule or degradation of performance. Is unlikely to overcome any difficulties, even with special contractor emphasis and close Government monitoring.

Unacceptable (U) Proposal does not meet requirements of the solicitation, and thus, contains one or more deficiencies, and/or risk of unsuccessful performance is unacceptable. Proposal contains a material failure or a combination of significant weaknesses that increases the risk of unsuccessful performance to an unacceptable level.

RESPONDENT IDENTIFICATION AND RATINGS

(Part 1 Contractor submitting Proposal fill-in)

Reference is provided for:

Contract Number:

Project Title:

Date of Award:

Project Completion Date:

Project Location:

Dollar Value: $

Brief Description of Proj:

Your role in referenced contract:

(Part 2 Person providing Reference)

Reference is provided by:

Company/Agency:

Business Address:

Telephone Number:

Email Address:

Project Completion Date:

Relationship to Contract:

If information in Part I is not accurate please indicate.

To obtain an electronic version of the form please contact: CMSgt Richard Lusby, 865-336-3353, richard.m.lusby.mil@mail.mil

THE QUESTIONNAIRE SHOULD BE SUBMITTED BY THE FOLLOWING MEANS: Return via email to the email address shown above.

Mark subject line: (Attention: RFP W912L7-17-R-0004 “Source Selection Sensitive Information”)

Please provide evaluation of the following Performance Elements by placing an X in the appropriate column that corresponds to the rating descriptions on the previous page.

mailto:richard.m.lusby.mil@mail.mil

COMPLIANCE WITH CONTRACT REQUIREMENTS

Outstanding Good Acceptable Margina l

Unaccep table

Not

Applica ble

(O) (G) (A) (M) (U) (N/A)

Quality of Service

Adequacy of Contractors Quality Control Plan

Identification/Correction of deficient work in a timely manner

Suggestion of solutions

Display of Initiative to implement solutions

Comments on Compliance with Contract Requirements:

EFFECTIVENESS OF PROJECT MANAGEMENT

(O) (G) (A) (M) (U) (N/A)

Contractor provided experienced managers and supervisors

Met Contract Requirements

Hired Experienced subconractors

Timley payment of employees/subcontractors/suppliers

Accuracy of proposals for modifications; Pricing was complete and reasonable; Provided Substantiating data

Site Manager ensured compliance with contract requirements & safety regulations

Site Manager acted promptly to resolve problems and ensure work quality

Site Manager has sufficient authority to makde decisions or take actios during performance

Site Manager consistently present on site when work was performed

Comments on Effectiveness of Project Management:

TIMELINESS OF PERFORMANCE

Was established schedule met

Resolution of delays in an expeditious manner

Identification/correction of deficient work in a timely manner

Comments on Timeliness of Performance:

COMMITMENT TO CUSTOMER SATISFACTION

Cooperation to resolve problems

Attendance of meetings

Maintain communication to assure satisfactory resolution

Overall customer satisfaction and willingness to foster a spirit of partnership with owner

Comments on Commitment to Customer Satisfaction:

Please provide any additional information you feel is important and not covered elsewhere in this evaluation:

Thank you for your remarks. Be sure to return to the Contracting Agency and not to the Contractor you are providing a reference for.

OFFEROR NAME___________________________

Respondent Signature ______________________________ Date Completed:______________________