Past_Performance_Questionnaire.docx
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- Fleet Law Enforcement Vehicle Upfit
- Solicitation number
- 12837119Q0025
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Fleet Law Enforcement Vehicle Upfit Solicitation No. 12837119Q0025 Attachment 8
SOURCE SELECTION SENSITIVE WHEN COMPLETED
**NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS**
PAST PERFORMANCE QUESTIONNAIRE
US Department of Agriculture, US Forest Service, Southwestern Region is considering the firm listed below. Your comments would be appreciated regarding this firm’s past performance.
Past Performance Information:
Name and Address of Firm Being Evaluated: _
| _ |
| _ |
| Contract No.: | Type of Contract: | _ Project Title: | _ |
| Date of Award: | _ Completion Date: | _ Location: |
Initial Amount: _ Final Amount: _ Description:
Evaluator: (The following information will assist in the analysis of the data)
Name of Evaluator: ____ Company/Agency Name: _ Address:
Phone Number: _ Email Address: _ Position Held or Function in Relation to Project:
Rating: If the rating is “Unacceptable”, please provide additional information in the appropriate block or in the remarks section of this form.
| “O” | Outstanding | Performance greatly exceeded the contract requirements. “G” | Good | Performance exceeded the contract requirements. |
| “A” | Acceptable | Performance met the contract requirements. | ||
| “M” | Marginal | Performance met the minimum contract requirements but some material aspects of the contractor’s performance were less than satisfactory. | ||
| “U” | Unacceptable | Performance was poor and/or did not satisfy contract requirements. |
Please circle the appropriate rating and provide any supporting information for the following:
| 1 |
| The relationship between the firm and client’s/customer’s contract team: |
| O G A M U N/A |
| 2 |
| The firm’s management and coordination of subcontractors/consultants: |
| O G A M U N/A |
| 3 |
| Overall corporate management, integrity, reasonableness and cooperative |
conduct:
O G A M U N/A
| 4 |
| Timeliness and quality of reports, deliverables, and other required submittals and |
documents:
O G A M U N/A
| 5 |
| The firm’s business integrity: |
| O G A M U N/A |
| 6 |
| Responsiveness to client/customer’s requirements: |
| O G A M U N/A |
| 7 |
| Ability to control costs and provide the required work at a reasonable total price: |
| O G A M U N/A |
| 8 |
| Contract Compliance: |
| O G A M U N/A |
| 9 |
| Contract Management: |
| O G A M U N/A |
| 10 |
| Compliance with safety standards and/or number of safety related incidents, code |
compliance, as applicable:
O G A M U N/A
| 11 |
| Performance of Public Relations related to construction: |
| O G A M U N/A |
| 12 |
| Quality Control Procedures: |
| O G A M U N/A |
| 13 |
| Construction and installation of asphalt roadways: |
| O G A M U N/A |
| 14 |
| Construction and installation of water systems: |
| O G A M U N/A |
| 15 |
| Construction and installation of wastewater systems: |
| O G A M U N/A |
| 16 |
| Performance of trailhead and trail construction: |
| O G A M U N/A |
| 17 |
| Installation of electrical systems: |
| O G A M U N/A |
| 18 |
| Performance of campground and/or picnic area reconstruction: |
| O G A M U N/A |
| 19 |
| Construction of bridges: |
| O G A M U N/A |
| 20 |
| Construction of concrete and aggregate pathways: |
| O G A M U N/A |
| 21 |
| Have any cure notices, show cause letters, letter of reprimand, suspension of |
payment, or termination been issued? If yes please explain:
Yes No
| 22 |
| Would you award another contract to the firm being evaluated: If no, please |
explain:
Yes No
| 23 | |
| Was the customer satisfied with the end product? If no, please explain: | |
| Yes | No |
| 24 |
| Has the firm being evaluated been provided an opportunity to discuss or respond |
to any negative comments or performance ratings? If so, what were the results?
Yes No
| 25 |
| Additional Remarks: |
| 26 |
| Overall rating for this firm: |
| O G A M U N/A |
Printed Name of Evaluator
Signature of Evaluator Date
This questionnaire should be submitted to the US Forest Service via email to Joni Dutcher at joni.dutcher@usda.gov
File details come from the government source that posted it.