09 Past Performance Questionnaire.pdf

ATTACHMENT 1, PRIOR EXPERIENCE ON RELEVANT PROJECTS - OFFEROR WORKSHEET

Project Title:

Location:

Name and location of the project.

A detailed description of the project:

Indicate if the project was performed under an IDIQ, blanket purchase agreement or other type of master contract:

Project start and completion dates:

Construction cost at award and the final construction cost at construction completion:

Describe your role in the project (i.e. prime or subcontractor):

Describe the amount and type of work you performed with in-house forces and the work that was accomplished by subcontractors:

Describe any problems encountered and the corrective actions taken:

Name, Phone number and email address of the client’s contact person, a primary contract and a secondary contact (at least one contact must be the owner):

If the team is proposing as a joint venture, the team will be required to discuss if the joint venture has experience working together in the past. If a team is proposing as a joint venture, the team will be required to provide a copy of the joint venture agreement.

ATTACHMENT 2, PBS PAST PERFORMANCE QUESTIONNAIRE

CONTRACT INFORMATION (Contractor/Offeror to complete Blocks 1-4)

1. CONTRACTOR/OFFEROR

INFORMATION

Firm Name:

Address:

Phone Number:

DUNs Number:

Contact Name Email Address:

Contact Phone Number:

2. GENERAL WORK INFORMATION

Work performed as: □ Prime Contractor □ Sub Contractor □ Joint Venture □ Other (Please explain):

Percent (%) of project work performed:

If a subcontractor, who was the prime (Name/Phone #):

3. CONTRACT INFORMATION

Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: □ Firm Fixed Price □ Cost Reimbursement □ Other (Please explain) Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. PROJECT DESCRIPTION

Complexity of Work: □ High □ Med □ Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

INSTRUCTIONS FOR CLIENTS COMPLETING THIS QUESTIONNAIRE: PBS requests that the client completes this questionnaire and submits it directly back to the offeror. The offeror will submit the completed questionnaire to

PBS with their proposal, and may duplicate this questionnaire for future submission on PBS solicitations. Clients are highly encouraged to submit questionnaires directly to the offeror. However, questionnaires may be submitted directly to PBS. Please contact the offeror for PBS POC information. The government reserves the right to verify any and all information on this form.

Use the following adjective ratings and definitions in your evaluation of the Contractor’s performance.

RATING DEFINITION NOTE

(E) Exceptional Performance meets contractual requirements and exceeds many to the Government/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

(G) Good Performance meets contractual requirements and exceeds some to the Government’s/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

A Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner. There should have been no significant weaknesses identified.

(S) Satisfactory Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified.

(M) Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions were only marginally effective or were not fully implemented.

A Marginal is appropriate when a significant event occurred that the contractor was not able to overcome timely or adequately, which negatively impacted the Government/Owner.

(U) Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor's corrective actions were ineffective.

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor was not able to overcome and which severely negatively impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

Use the following adjective ratings and definitions in your evaluation of the Contractor’s performance.

(N) Not Applicable No information or did not apply to your contract

Rating will be neither positive nor negative.

TO BE COMPLETED BY CLIENT

CLIENT INFORMATION

Client Point of Contact Information Name:

Title:

Phone Number:

Email Address:

Project Information Contract Type:

Contract Title:

Contract Location:

Describe your role in the project:

Date Questionnaire was completed (mm/dd/yy):

Client’s Signature:

Instructions: Please select the adjective rating that best reflects your evaluation of the contractor’s performance.

1. QUALITY: E G S M U N

(a) Quality of technical data/report preparation efforts. □ □ □ □ □ □

(b) Ability to meet quality standards specified for technical performance. □ □ □ □ □ □

(c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance. □ □ □ □ □ □

(d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance).

2. SCHEDULE/TIMELINESS OF PERFORMANCE: E G S M U N

(a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below.)

(b) Rate the contractor’s use of available resources to accomplish tasks identified in the contract. □ □ □ □ □ □

3. CUSTOMER SATISFACTION: E G S M U N

(a) To what extent were the end users satisfied with the project? □ □ □ □ □ □

(b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve □ □ □ □ □ □

CLIENT INFORMATION

disagreements/disputes; responsiveness to administrative reports, businesslike and communication).

(c) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer? □ □ □ □ □ □

(d) Overall customer satisfaction. □ □ □ □ □ □

4. MANAGEMENT/ PERSONNEL/LABOR E G S M U N

(a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force? □ □ □ □ □ □

(b) Ability to hire, apply, and retain a qualified workforce to this effort. □ □ □ □ □ □

4. MANAGEMENT/ PERSONNEL/LABOR - Continued E G S M U N

(c) Government Property Control. □ □ □ □ □ □

(d) Knowledge/expertise demonstrated by contractor personnel. □ □ □ □ □ □

(e) Utilization of Small Business concerns. □ □ □ □ □ □

(f) Ability to simultaneously manage multiple projects with multiple disciplines. □ □ □ □ □ □

(g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes.

(h) Effectiveness of overall management (including ability to effectively lead, manage and control the program). □ □ □ □ □ □

5. COST/FINANCIAL MANAGEMENT E G S M U N

(a) Ability to meet the terms and conditions within the contractually agreed price(s)? □ □ □ □ □ □

(b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client.

(c) If this is/was a Government cost type contract, or a CMc/CMc at Risk Contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns).

(d) Is the Contractor’s accounting system adequate for management and tracking of costs? (If no, please explain in comment section below.)

□ Yes

□ No

(e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? (Indicate if show cause or cure notices were issued, or any default action in comment section below.)

□ Yes

□ No

CLIENT INFORMATION

(f) Have there been any indications that the contractor has had any financial problems? (If yes, please explain in the comment section below.)

□ Yes □ No

6. SAFETY/SECURITY E G S M U N

(a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.).

(b) Contractor complied with all security requirements for the project and personnel security requirements. □ □ □ □ □ □

7. GENERAL E G S M U N

(a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

(b) Compliance with contractual terms/provisions (If there were specific issues, please explain in the comments sections below □ □ □ □ □ □

(c) In summary, provide an overall rating for the work performed by this contractor. □ □ □ □ □ □

8. SUSTAINABILITY

Did this project include sustainable methods, materials, processes or certifications? (See Whole Building Design Guide for acceptable requirements. Link to guide WBDG Green Building Standards and Certification Systems.) (If yes, please explain in the comments section below.)

□ Yes□ No

9. SUMMARY

Would you hire or work with this firm again? (If no, please explain in the comments section below.) □ Yes□ No

Please provide responses to the above questions (if applicable) and/or additional remarks. Also please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):