36C24818R0082-002.doc

PAST PERFORMANCE QUESTIONNAIRE

TO BE COMPLETED BY REFERENCED CLIENT: Please return this completed Questionnaire via e-mail to Thomas Lucas, the requesting Contracting Officer at the following email addresses: Thomas.Lucas@va.gov No later than 5 calendar days prior to RFP closing date.

Note: When sending back to Contract Specialist by email – ensure the following: Ensure Email Subject line is as follows:

36C24818R0082, Design/Build Pump Station, Company Name Contract Number:

Project Title:

Contract Amount:

Contractor:

Rating scale is as follows: O=Outstanding, G=Good, S=Satisfactory, M=Marginal, U=Unsatisfactory, N=Neutral The full rating definitions are listed after the questionnaire for reference.

1. In regards to performance, how was the contractor’s adherence to technical requirements of the contract? O G S M U N COMMENTS/REMARKS: ______________________________________________________________________________________

2. Was performance completed in accordance with planned progress schedule? (Note – Notwithstanding changes that are legitimate to extend performance.

O G S M U N

COMMENTS/REMARKS:

3. Were Material Submittals, Payrolls, Quality Control Plan, Safety Plans etc. submitted in a timely manner? O G S M U N

COMMENTS/REMARKS:

4. Does the contractor submit an excessive number of change orders or inundate the contract management team? O G S M U N

COMMENTS/REMARKS:

5. Was Project Management effective? (to include use and control of subcontractors) O G S M U N

COMMENTS/REMARKS:

6. How was the contractor’s design build team and rate how well they accomplished design build projects (to include use and control of subcontractors) O G S M U N

COMMENTS/REMARKS:

7. Would you hire this contractor again?

COMMENTS/REMARKS:

· Yes

· No

8. How would you rate the contractor’s OVERALL PERFORMANCE?

O G S M U N

COMMENTS/REMARKS:

Signature of Rater: ____________________________________

Date: ________________

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

Outstanding

The offeror’s performance of previously awarded relevant contracts met contractual requirements and exceeded many to the government’s benefit. The company performed with very few or very minor problems, for which corrective actions taken were, or are expected to be, highly effective. Performance of completed contracts was either consistently of the highest quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an extremely strong expectation of successful performance.

Good

The offeror’s performance of previously awarded relevant contracts met contractual requirements and exceeded some to the government’s benefit. The company performed with few or minor problems, for which corrective actions taken were, or are expected to be, effective. Performance of completed contracts was either consistently of the good quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an expectation of successful performance.

Satisfactory

The offeror’s performance of previously awarded relevant contracts met contractual requirements. The company performed with some problems, for which corrective actions taken by the contractor were, or are expected to be, effective. Performance of completed contracts was consistently of adequate or better quality or exhibited a trend. The offeror’s past performance record leads to an expectation of successful performance.

Marginal

The offeror’s performance of previously awarded relevant contracts did not meet some contractual requirements. The contractor’s performance reflected some serious problems, performance reflected some serious problems, for which the contractor either failed to identify or implemented corrective actions in a timely manner, or for which the corrective actions implemented or proposed to be implemented were, or are expected to be, only partially effective. Performance of completed contracts was consistently of mediocre quality or exhibited a trend toward becoming so. The offeror’s past performance record leads to an expectation that successful performance might be difficult to achieve or that it can occur only with increased levels of government management and over sight.

Unsatisfactory

The offeror’s performance of previously awarded relevant contracts did not meet contractual requirements, and recovery, if any, did not occur within the period of performance. The contractor’s performance reflected serious problems for which the offeror either failed to identify or implement corrective actions were mostly ineffective. Performance of completed contracts was consistently of poor quality or exhibited a trend toward becoming so. The offeror’s past performance will not be achieved or that it can occur only with greatly increased levels of government management and oversight.

Neutral

The offeror lacks a record of relevant or available past performance history. Based on this, there is no expectation of either successful or unsuccessful performance.