Past Performance Relevant Experience Questionaire.pdf

Past Performance Questionnaire

Contractor Information:

Firm Name:

Point of Contact at the Firm:

POC Phone Number:

POC Email:

Project Information:

Contract/Task Order Number:

Project Title:

Project Description:

Project Location:

Award Date: Completion Date:

Actual Completion Date:

Explain Difference:

Original Contract Price:

Final Contract Price:

Explain Difference:

CLIENT’S ASSESSMENT OF THE CONTRACTOR

Client Information:

Business/Organization Name:

Point of Contact for the Client:

Title:

Phone Number:

Email:

Point of Contact’s Role in the Project:

Date Questionnaire Completed:

Client’s Signature:

Rating Scale:

EXCEPTIONAL

(5)

Performance EXCEEDS MOST contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns.

VERY GOOD

(4)

Performance EXCEEDS SOME contractual requirements to the Government’s benefit. The performance of areas being assessed was accomplished with few minor issues or concerns, for which the Contractor’s corrective actions were highly effective.

SATISFACTORY

(3)

Performance MEETS contractual requirements. The performance of the areas being assessed contains minor issues or concerns, for which corrective actions taken by the Contractor were effective.

MARGINAL

(2)

Performance MEETS SOME contractual requirements. The performance of the areas being assessed includes significant problems, issues, or concerns for which corrective actions taken by the Contractor were only somewhat effective.

UNSATISFACTORY

(1)

Performance DOES NOT MEET contractual requirement. The performance of the areas being assessed includes serious problems, issues, or concerns for which the Contractor’s corrective actions were ineffective.

NOT APPLICABLE

(N/A)

Performance information not recent or relevant as defined in the Solicitation.

Unable to provide assessment.

Quality of Product or Service:

N/A 1 2 3 4 5 Quality of Deliverable (Met Specifications) Conformance to good standards of workmanship Adequacy of the QC Plan Implementation of the QC Plan Quality of QC Documentation Identification/Correction of Deficient Work Adequacy of Submittals Use of Specified Materials Comments:

Cost Control:

N/A 1 2 3 4 5

Ability to meet the terms and conditions within the contractually agreed price(s) Were invoices current, accurate, and complete Reasonableness of price change proposals submitted Proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client Comments:

Schedule:

N/A 1 2 3 4 5

Adequacy of Initial Schedule Adherence to Approved Schedule Resolution of Delays Timely submission of Required Documentation Timely submission of Updated and Revised Schedules Comments:

Management / Business Relations:

N/A 1 2 3 4 5

Management of Resources/Personnel Key Personnel were Utilized Appropriately and Effectively Coordination and Control of Subcontractors Professional Conduct Review/Resolution of Subcontractor’s Issues Change Order Activity (By Contractor) Maintains an Adequate Work Force Responsiveness to Corrective Actions Identifies and Mitigates Risk Comments:

Regulatory Compliance:

N/A 1 2 3 4 5

Complied With Contract Clause Requirements Complied With Reporting Requirements Complied With Design Requirements Compliance With Labor Laws And Regulations Complied With Safety Laws And Regulations Correction Of Noted Deficiencies Comments:

Overall Rating:

N/A 1 2 3 4 5

Overall Rating Comments:

Recommendation Given what you know today about the contractor’s ability to perform the work required, would you recommend the selection of this firm for similar requirements in the future?

Would Would Not

APPENDIX E

Construction Experience Form

Experience For:

(Firm Name) Point of Contact:

Phone:

Construction Project Information:

Construction Project Title:

Contract / Project Number:

Location:

Award Date: Completion Date:

Explain Difference:

Award Amount: Final Amount:

Explain Difference:

Owner:

Point of Contact for Owner:

Phone:

Email:

Type of Contract:

Firm Fixed Price Other (Explain) :

Cost Reimbursement

Role: Prime Contractor Other (Explain):

Sub Contractor Joint Venture