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PAST PERFORMANCE QUESTIONNAIRE
A&E IDIQ NEA
12305B21R0007 INSTRUCTIONS: Offeror to complete Sections A and B and transmit questionnaire to reference.
Reference to complete Sections C and D.
A. CONTRACTOR INFORMATION
| Unique Entity ID (DUNS) |
| XXXXXXX |
| Point of Contact |
| Name, Email, Phone |
B. CONTRACT INFORMATION
| Contract Number |
| XXXXXXXXXX |
| Awarded Contract Price |
| $X,XXX,XXX |
| Current / Final Price |
| $X,XXX,XXX |
| Contract Award Date |
| XX/XX/XXXX |
| Contract Completion Date |
| XX/XX/XXXX |
| Period of Performance |
| XX/XX/XXX – XX/XX/XXX |
| Project Location |
| Park or Street address, City, State |
| Brief description of the contract & work effort: |
| Scope of work description |
C. REFERENCE:
| Organization |
| Agency or Company |
| Phone Number |
| XXX-XXX-XXXX |
D. EVALUATION
| Exceptional |
| Performance met contractual requirements and exceeded many to the owner’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
| Very Good |
| Performance met contractual requirements and exceeded some to the owner’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| Satisfactory |
| Performance met contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| Marginal |
| Performance did not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. |
| Unsatisfactory |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective. |
Quality
| Quality of workmanship (including subconsultants when applicable)? |
| Choose an item. |
| Quality of and adherence to quality control plan? |
| Choose an item. |
| Quality of informational and design submittals? |
| Choose an item. |
| Overall Quality Rating |
| Choose an item. |
| Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.): |
Schedule (& Time Management)
| Met project schedule milestones? |
| Choose an item. |
| Responded to owner requests in a timely manner? |
| Choose an item. |
| Informational and design submittals submitted timely? |
| Choose an item. |
| Promptly addressed scheduling issues? |
| Choose an item. |
| Overall Schedule (& Time Management) Rating |
| Choose an item. |
| Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.): |
Cost Control
| Addressed design alterations and/or changes as to minimize additional costs? |
| Choose an item. |
| Provided fair and reasonable pricing for contract modifications? |
| Choose an item. |
| Submitted accurate and complete invoices? |
| Choose an item. |
| Designed with funding limits? |
| Choose an item. |
| Overall Cost Control Rating |
| Choose an item. |
| Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.): |
Management
| General oversight by project manager? |
| Choose an item. |
| Coordination with and control of subcontractors/subconsultants (where applicable)? |
| Choose an item. |
| Addressed location factors (especially remote locations)? |
| Choose an item. |
| Maintained good working relationship with owner representatives? |
| Choose an item. |
| Demonstrated flexibility, innovativeness and cooperation in resolving potential problems? |
| Choose an item. |
| Overall Management Rating |
| Choose an item. |
| Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.): |
Small Business Subcontracting (& Labor Standards)
| Met regulatory and contractual standards? |
| Choose an item. |
| Successfully contracted with small and socio-economically disadvantaged businesses? |
| Choose an item. |
| Quality and adherence to applicable subcontracting plans? |
| Choose an item. |
| Overall Small Business Subcontracting (& Labor Standards) Rating |
| Choose an item. |
| Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.): |
Regulatory Compliance
| Met building and regulatory requirements (i.e. Buy American Act)? |
| Choose an item. |
| Overall Regulatory Compliance Rating |
| Choose an item. |
| Overall Recommendation: |
| Given what I know today about the contractor's ability to perform in accordance with the contract’s most significant requirements, I would recommend them for similar contracts: |
| Choose an item. |
| Overall Comments: |
E. EVALUATOR SIGNATURE:
Name Date Position/Title