Attachment 7 - Past Performance Questionnaire.docx

US Forest Service – Request for Proposals – 12010920R0001 – Stream Crossing Improvements

PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire and email to mari.meiners@usda.gov or stacy.doutt@usda.gov or michael.t.mccarthy@usda.gov:

OFFEROR company contact information

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options):

6. TYPE OF CONTRACT:

7. DESCRIPTION OF CONTRACT REQUIREMENTS:

Please add a continuation page if additional space necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION: a. EVALUATOR'S NAME, POSITION (Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

EVALUATOR EMAIL:

Please circle the response code for each topic (A – G) that best reflects your experience with this contractor.

O = Outstanding VG = Very Good S = Satisfactory U = Unacceptable N/O = Not Observed

A. Quality of Products and Services - Assess the quality of the contractor’s performance including conformance to contract requirements, specifications, and standards of good workmanship.

O VG S U N/O

B. Commitment to Customer Satisfaction – Assess the contractor’s responsiveness to customer concerns and “user friendliness”.

O VG S U N/O

C. History of Reasonable and Cooperative Behavior – Assess the contractor’s history of cooperation with project owner personnel including timely identification of issues and ability to resolve conflicts and negotiate changes in a reasonable and professional manner.

O VG S U N/O

D. Conformance With Contract Schedules – Assess the timeliness of contractor against the schedule of activities.

O VG S U N/O

E. Management – Assess management’s ability to coordinate all activities needed for performance; timeliness, completeness and quality of problem identification; management of subcontracts; and adequate planning, scheduling and managing the work.

O VG S U N/O

F. Regulatory Compliance – Assess the contractor’s history of compliance with regulatory requirements such as OSHA, Labor Laws, Environmental Laws, etc. –

O VG S U N/O

G. Overall Assessment – Assess the contractor' overall performance on this project

O VG S U N/O

Add Additional Comments below:

A. Quality of Products and Services

B. Commitment to Customer Satisfaction

C. History of Reasonable and Cooperative Behavior

D. Conformance with Contract Schedules

E. Management

F. Regulatory Compliance

G. Overall Assessment

H. If given the opportunity, would you choose to work with this contractor again? Yes [ ] No [ ]

Check the appropriate boxes for all work elements included in the referenced project:

☐ In-stream construction of large culverts (>72” diameter), including Aquatic Organism Passage Projects

☐ Installation of modular bridges

☐ Construction/contouring of streambanks adjacent to culvert/bridge structures and placement of key rocks

☐ Implementation and maintenance of an erosion control plan

☐ Construction surveying and staking

☐ Dewatering the construction zone

☐ Placement of new structure(s) (culvert or bridge) based on government approved specifications

☐ Cast-in-place concrete work

☐ Placement of fill, crushed rock, and road surfacing work

☐ Risk assessment and mitigation for readiness in a remote environment similar to that encountered in Southeast Alaska (e.g. maintaining equipment function; availability of spare and repair parts; able mechanical operators and maintenance personnel)