FAA ATSA Screening Information Request Part IV– Section L

SIR No. DTFAWA-19-R-00023 Section L – Attachment L002 - Past Performance Questionnaire

PAST PERFORMANCE EVALUATION QUESTIONNAIRE (L002)

INSTRUCTIONS TO OFFERORS SENDING REFERENCE QUESTIONNAIRE FORMS:

Section A (Part I and Part II) shall be completed by the Offeror (the firm requesting the reference) prior to
issuing the questionnaires. The Offeror shall send the questionnaires for three (3) relevant projects that are
referenced in its Technical Proposal that are in progress or completed in the past three (3) years to the
individuals who will provide the reference. For Government contracts, send to the Contracting Officer (CO)
or CO’s Technical Representative. For commercial references, send to personnel with duties similar to
those for Government contracts. It is the responsibility of the Offeror to follow-up and encourage references
to submit the questionnaire. The completed questionnaire shall be submitted via e-mail directly from the
person providing the reference. In addition, copies of all requested questionnaire forms by the Offeror to the
Reference source must be included with the Offeror’s proposal due 2PM EST, on October 09, 2019.

INSTRUCTIONS TO PERSON PROVIDING REFERENCE:

In order to assess potential vendors under the FAA Air Traffic ­ Skills Assessment" (ATSA) Competition,
the FAA contracting office is obtaining past performance information with respect to each Offeror. As a
reference for work performed by the firm identified in Section A of this questionnaire, your candid response
will assist in the evaluation process. Please complete Section B (Part I and Part II) of the questionnaire as
thoroughly as possible and submit to Toloria.J.Crawford@faa.gov and Francisco.Felix@faa.gov no later
than 2PM EST, on October 15, 2019. The subject line in the submission e-mail shall clearly indicate: FAA
ATSA Past Performance Questionnaire Submission for <Company Name> and the message shall originate
from the reference’s government or commercial e-mail system.

In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information.
Your input into this evaluation is greatly appreciated. If you have questions regarding this questionnaire or
require assistance, please submit inquiries to: Toloria.J.Crawford@faa.gov or call (202) 267-4048.

Toloria J. Crawford
Branch Manager, AAQ-420
Acquisition & Business Services

Attachment L002– Page 1

FAA ATSA Screening Information Request Part IV– Section L
SIR No. DTFAWA-19-R-00023 Section L – Attachment L002 - Past Performance Questionnaire

SECTION A
TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)
PART I: FAA INTERN PROGRAM OFFEROR INFORMATION
COMPANY NAME OF OFFEROR:
OFFEROR ADDRESS:

COMPANY NAME OF PEARS II PERFORMING TEAM MEMBER FOR THIS REFERENCE (IF APPLICABLE):

TEAM MEMBER ADDRESS:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT/CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:

AGENCY/CUSTOMER

CONTRACT/ORDER/SUBCONTRACT/OTHER:

CONTRACT TYPE: (Check all that apply)

FP CPFF-Completion CPFF-Term CPIF CPAF IDIQ/Task Order

Requirements Labor-Hour T&M CR Other (Specify) _______________

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACT AMOUNT:

• INITIAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

• FINAL CONTRACT DOLLAR VALUE (W/OPTIONS): _________________

ROLE ON PROJECT:

PRIME

SUBCONTRACTOR (EXPLAIN TYPE AND EXTENT OF SUBCONTRACTING, IF APPLICABLE):

OTHER (EXPLAIN)

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FAA ATSA Screening Information Request Part IV– Section L
SIR No. DTFAWA-19-R-00023 Section L – Attachment L002 - Past Performance Questionnaire

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE COMPLEXITY OF WORK:

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FAA ATSA Screening Information Request Part IV– Section L
SIR No. DTFAWA-19-R-00023 Section L – Attachment L002 - Past Performance Questionnaire

SECTION B
TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)
PART I: REFERENCE INFORMATION
NAME & TITLE:
ORGANIZATION (INCLUDING AGENCY AND/OR COMPANY):
CONTRACT ROLE (e.g. CO, COTR):
ADDRESS:
PHONE NUMBER:
FAX NUMBER:
E-MAIL:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

Please identify and correct any information that is not accurate in Section A.
Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most
appropriate rating as described below:

Performance Exceptional Very Good Satisfactory Marginal Unsatisfactory

Element

1. Technical · Met all · Met all · Met all · Some · Most

Performance performance performance performance performance performance
/ Quality of requirements / requirements / requirements requirements not requirements are
Service Exceeded 20 % Exceeded 5% or · Minor problems / met not met
or more more Satisfactory · Performance · Recovery not
· Minor problems / · Minor problems / corrective actions reflects serious likely
Highly effective Effective problem /
corrective actions corrective actions Ineffective
/ Improved corrective actions
performance/qual
ity results

Assessment
(Check Box)

2. Cost Control · Significant · Reduction in · Met overall · Do not meet · Significant

reductions while overall cost/price cost/price cost/price cost overruns
having met all while having met estimates while estimates · Not likely to
contract all contract having met all · Inadequate recovery cost
requirements requirements contract corrective control
· Use of value · Use of value requirements action plans /
engineering or engineering or No innovative
other innovative other innovative techniques to
management management bring overall

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FAA ATSA Screening Information Request Part IV– Section L
SIR No. DTFAWA-19-R-00023 Section L – Attachment L002 - Past Performance Questionnaire

techniques techniques expenditures

· Quickly resolved · Quickly resolved within limits
cost issues / cost/price issues /
Effective Effective
corrective actions corrective actions
facilitated cost to facilitate
reductions overall cost/price
reductions

Assessment
(Check Box)

3. Schedule · Significantly · On-Time · On-time · Some late · Many late

(Timeliness) exceeded deliveries / Some deliveries deliveries deliveries
delivery early deliveries · Minor problems / · No corrective · Negative cost
requirements (All to the Did not effect actions impact / Loss
on-time with Government’s delivery schedule of capability
many early benefit for
deliveries to the · Quickly resolved Government
Government’s delivery issues / · Ineffective
benefit) Effective corrective
· Quickly resolved corrective actions actions / Not
delivery issues / likely to
Highly effective recover
corrective actions

Assessment
(Check Box)

4. Business · Highly · Professional / · Professional / · Less · Delinquent

Relations professional / Responsive Reasonably Professionalism responses /
Responsive / · Exceeded responsive and Lack of
Proactive expectations · Met expectations Responsiveness cooperative
· Significantly · User satisfaction · Adequate user · Low user spirit
exceeded · Exceeded satisfaction satisfaction / No · Unsatisfied
expectations subcontractor · Met attempts to user / Unable
· High user goals subcontractor improve to improve
satisfaction · Limited change goals relations relations
· Significantly proposals / Timely · Reasonable · Unsuccessful in · Significantly
exceeded definitization of change proposals meeting under
SB/SDB change proposals / Reasonable subcontractor subcontractor
subcontractor definitization goals goals
goals cycle · Unnecessary · Excessive
· Minor changes change unnecessary
implemented proposals / change
without cost Untimely proposals to
impact / Limited definitization of correct poor
change proposals change management
/ Timely proposals · Significantly
definitization of untimely
change proposals definitization
of change
proposals

Attachment L002– Page 5

FAA ATSA Screening Information Request Part IV– Section L
SIR No. DTFAWA-19-R-00023 Section L – Attachment L002 - Past Performance Questionnaire

Assessment
(Check Box)

YES NO
FOR #5, PLEASE ANSWER “Yes” or “No”, as
appropriate

5. Given the choice, would you do business with this

contractor again?
6. Additional comments you would like to share

_____________________________ ____________________
SIGNATURE DATE:

Attachment L002– Page 6