2023 1112 Contractor Reference Form.doc

REFERENCE QUESTIONNAIRE PACKAGE

INFORMATION AND FORMS

Instructions to Offeror for sending Reference Questionnaire Forms:

Offeror: Prepare and send a reference questionnaire package for each relevant project listed on your proposal. Send to Contracting Officer or Technical Representative. It is your responsibility to follow-up and to encourage your references to send in their questionnaire. Your questionnaire package should contain the following.

Cover Letter

Past Performance Evaluation Questionnaire

Complete Part 1 (To Be Completed by Firm Requesting Reference) of each Questionnaire before sending it to the individual who will be providing the reference.

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

SAMPLE TRANSMITTAL LETTER

Your Company Letterhead

Date: _________________

To: ______________________________________

We have listed you as a reference for work we have performed for your firm as noted on the attached questionnaire. Our firm intends to submit a proposal under a project advertised by the US Forest Service (USFS) Southwestern Region Engineering for a CERCLA Environmental Response Actions Indefinite Delivery/Indefinite Quantity (IDIQ) Contract for projects located on National Forests. In accordance with the Federal Acquisition Regulations, the USFS will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments.

Please send your completed questionnaire to the following address to arrive NOT LATER

THAN March 23, 2023.

Via email (scanned signed copy) to: david.l.watson@usda.gov maria.mcgaha@usda.gov Questionnaires may be mailed, faxed or e-mailed to the above address. E-Mail is preferred.

If you have questions regarding the attached questionnaire, or require assistance, please contact the individual named above. Thank you for your assistance.

Signature and Title

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Part 1 (To Be Completed by Firm Requesting Reference)

1. Name/Title, Firm Name & Address (City and State):

2. Title of Project/Contract Number:

3. Description of Project for Which Reference is Requested (Include type of work/trades performed):

4. Complexity of Work: High ________ Mid _________ Routine __________

5. Location of Work: ______________________________________________

6. Role on Project: FORMCHECKBOX Prime FORMCHECKBOX Subcontractor

7. Contract Amount: _______________________________

8. Date of Award: ________________________

9. Status: Percent complete __________

Project Completion Date: Scheduled FORMCHECKBOX Actual FORMCHECKBOX

Part 2 (To Be Completed by Person Providing Reference)

Reference is provided by: ____________________________

Company/Agency: _________________________________________________________________

Business Address; ________________________________________________________________

Telephone Number: _______________________________________________________________

E-Mail Address: __________________________________________________________________

Relationship to Contract: ___________________________________________________________

If the information provided in Part 1 is not accurate, please indicate and correct.

Return completed questionnaire (pages 1-4) via FAX (*number), or via email to *email address, or forms may be mailed to: *Maria McGaha at 333 Broadway Blvd SE, Albuquerque, NM 87102 or scanned signed copy to maria.mcgaha@usda.gov. Mark cover sheet of fax/subject line of e-mail/outside of envelope: Attention: “R3 CERCLA IDIQ Solicitation – XXXXXXXXX - Reference Questionnaire” Reply due date is XXXXXX

1. QUALITY OF WORK

Question:

Was this project relevant to CERCLA and/or environmental remediation? Yes ____No___

Evaluate performance in complying with contract requirements, quality achieved and overall technical expertise demonstrated. Please circle most accurate rating accordingly:

A - Excellent Quality B - Above Average Quality

C - Average Quality

D - Below Average Quality

F - Unsuccessful or Experienced Significant Quality Problems

Remarks:

2. TIMELINESS OF PERFORMANCE

Question:

To what extent were contract performance requirements met? Consider also such things as; contract performance period requirements; provided submittals in a timely manner; timely completion of punch-list items; timely submission of deliverables, i.e., “project completion report”. Mark with X most accurate assessment accordingly:

___ Completed substantially ahead of schedule

___ Completed on schedule with no time delays

___ Completed on schedule with minor delays under extenuating circumstances

___ Other (explain) ___________________________________________________ Remarks:

3. DOCUMENTATION

Question(s): To what extent were reports, submittals and other required documentation accurate, complete?

Evaluate performance in complying with contract requirements, quality achieved and overall technical expertise demonstrated. Please circle most accurate rating accordingly:

A - Excellent Quality

B - Above Average Quality

C - Average Quality

D - Below Average Quality

F - Unsuccessful or Experienced Significant Quality Problems

Remarks:

4. COORDINATION AND COMMUNICATION

Question(s): How well did contractor communicated during the period of performance. How well did they respond to coordination efforts and work with project client and subcontractors? Were there any problems and, if so, how were they handled?

Please circle most accurate rating accordingly:

A - Excellent Quality

B - Above Average Quality

C - Average Quality

D - Below Average Quality

F - Unsuccessful or Experienced Significant Quality Problems

Remarks:

5. GENERAL MANAGEMENT PRACTICES

Question(s): How well managed were the firm’s general business practices? Consider such things as provided quality, experienced managers, technical and administrative personnel throughout the project; was promptly available when needed, and responded in a prompt and acceptable manner to resolve problems, provided accurate price proposals.

Please circle most accurate rating accordingly:

A - Excellent Quality

B - Above Average Quality

C - Average Quality

D - Below Average Quality

F - Unsuccessful or Experienced Significant Quality Problems

Remarks:

6. GENERAL MANAGEMENT PRACTICES

Question(s): How well did the contractor manage the construction as it relates to safety? Discuss any Safety issues that arose during the course of the construction.

Please circle most accurate rating accordingly:

A - Excellent Quality

B - Above Average Quality

C - Average Quality

D - Below Average Quality

F - Unsuccessful or Experienced Significant Quality Problems

Remarks:

7. COST CONTROL

Question(s): How well did the firm conform to the project budget? Did the applicant initiate unwarranted contract modifications (change orders) or change order requests?

Please circle most accurate rating accordingly:

A - Excellent Quality

B - Above Average Quality

C - Average Quality

D - Below Average Quality

F - Unsuccessful or Experienced Significant Quality Problems

Remarks:

8. CLAIMS/LITIGATION

Question(s): Was the applicant involved in any claims or litigation surrounding the project?

FORMCHECKBOX

Yes

FORMCHECKBOX

No If “Yes”, please explain Remarks:

9. CUSTOMER SATISFACTION:

Question(s): To what extent were the end users satisfied with: Quality? Cost? Schedule?

Exceptionally Satisfied

Q____ C_____S____

Highly Satisfied

Satisfied

Somewhat Dissatisfied (please explain)

Q____ C_____S____

If given the opportunity, would you work with this firm again?

Yes ___________ No ____________ Not Sure ____________

Remarks:

OTHER REMARKS:

Use the space below to provide other information related to the contractor's performance.

This may include selection of subcontractors, flexibility in dealing with contract challenges, payment issues, their overall concern for the client's interest (if applicable), project awards received, etc.

R3 CERCLA IDIQ SOLICITATION