Attachment 1 - PAST PERFORMANCE QUESTIONNAIRE.pdf

Attachment 1

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NUMBER W91SMC-11-T-0014

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

182 Airlift Wing, ATTN: MSgt Melissa Grice, Base Contracting Officer 2416 S. Falcon Blvd.

Peoria, IL 61607

DSN phone: 724-5204 Commercial phone: (309) 633-5204 DSN fax: 724-5539 Commercial fax: (309) 633-5539

2. Explanation of codes:

CODE PERFORMANCE LEVEL

E EXCEPTIONAL - Performance meets contractual requirements and exceeds many flooring 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 flooring 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 not applicable to effort assessed.

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

A. Contractor:

B. Contract number:

C. Period of Performance: __________________ D. Negotiated price or cost at award:

E. Current estimated contract dollar amount: __________________ F. Describe product acquired:

4. Circle the appropriate letter for each item on the questionnaire and provide supporting narrative.

ASSESSMENT ELEMENTS

(1) Contractor’s Quality of Work. Did the product or service meet the required level of quality?

E V S M U N

(2) Contractor’s Timely Performance. Did the contractor deliver according to the agreed-to schedule?

What were the causes of any schedule variances?

(3) Contractor’s Management. How effective was the contractor at dealing with management issues?

Were supervisors and managers experienced? Knowledgable?

(4) Compliance with Labor Standards. Did the contractor adhere to all rules and regulations?

(5) Compliance with Safety Standards. What was the attitude toward safety? Was the contractor proactive at resolving safety issues or concerns?

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

(7) Identify the contractor's overall strengths and weaknesses.

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

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

(If more comment space needed, write on back, or attach pages.)

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

Phone ________ FAX_________________

6. Thank you for your assistance in this award process. If you have any questions, please call MSgt Melissa Grice at (309) 633-5204.

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