Attch_8_Performance_Questionnaire.pdf

Solicitation #: 12344V18Q0013

Performance Questionnaire: Page 1 of 3

Factor 2 – Past Performance Questionnaire

Offeror: Complete this section before submitting to your reference for completion.

Contractor: ___________________________________________________________________

Address: _____________________________________________________________________

Phone/FAX: __________________________________________________________________

Point of Contact: ______________________________________________________________

Contract Number: _____________________________________________________________

Contract Period or Dates of Performance: ______________________________________

Respondent: Complete from here on.

Respondent/Title: ____________________________________________________________

Organization/Firm: ____________________________________________________________

Address: _____________________________________________________________________

Phone/FAX: ________________________________________________________________

Email: _____________________________________________________________________

Please provide the following information concerning the performance of this contractor with your firm:

Note: If any of the above provided information is incorrect, make corrections. If the contractor holds or has held other contracts with your organization/firm in the last 3 years, please complete separate evaluation forms for those contracts as well.

Contractor performed as: ___ PRIME Contractor ___ SUB-Contractor

Contract dollar value: _________________________________________________________

Scheduled performance period: _________________________________________________

Actual performance period: ____________________________________________________

Description of work performed:

Performance Questionnaire: Page 2 of 3

Circle the number on the scale below that most accurately describes the contractor’s performance.

Provide a narrative explanation if rating 1 or 6 is selected.

1 2 3 4 5 6

Unsatisfactory Marginal None Satisfactory Very Good Exceptional Performance did Not meet most Contractual requirements.

There were serious problems and the contractor’s corrective actions were ineffective

Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective.

No record of past performance or the record is inconclusive.

Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory

Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems which the contractor resolved in a timely, effective manner.

Performance met all contract requirements and exceeded many to the government’s benefit. Problems, if any, were negligible and were resolved in a timely, highly effective manner.

Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

1 2 3 4 5 6 NA

Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period. Did contractor hire quality sub-contractors? If no, list poor sub-contractors in “remarks".

1 2 3 4 5 6 NA

3 Paid subcontractors/ suppliers in a timely manner. 1 2 3 4 5 6 NA

4 Quality of initial workmanship (no rework required) 1 2 3 4 5 6 NA

5 Overall quality of workmanship 1 2 3 4 5 6 NA

6 Timely, effective resolution of warranty or defects 1 2 3 4 5 6 NA

7 Deficiencies/discrepancies reported and resolved in a timely manner 1 2 3 4 5 6 NA

8 Initiative in solving problems. 1 2 3 4 5 6 NA

9 Project completion time 1 2 3 4 5 6 NA

10 Developed and met realistic progress schedules 1 2 3 4 5 6 NA

11 Project managers/supervisors given sufficient authority 1 2 3 4 5 6 NA

12 Adequate project supervision 1 2 3 4 5 6 NA

13 Quality control effective and sufficient. 1 2 3 4 5 6 NA

Complete and accurate proposals provided with sufficient line item break out to identify price for each aspect of work.

1 2 3 4 5 6 NA

15 Cooperative with government personnel after award. 1 2 3 4 5 6 NA

Was the contractor ever issued a cure or show cause notice under the referenced contract? If “yes”, explain in “remarks”.

YES NO

Would you award another contract to this contractor? If not, explain in “remarks”. YES NO

Performance Questionnaire: Page 3 of 3

REMARKS:

Fax or Email completed form to: Michael L. Johnson, (360-891-5081, mljohnson-2@fs.fed.us)