ATTACHMENT 1 PAST PERFORMANCE QUESTIONNAIRE.pdf

ATTACHMENT 2

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

SUBJECT: Request for Past and Present Performance Evaluation

TO: ________________________________________________ (to be completed by the Offeror)

You have been identified as a point of contact for a past and/or present performance evaluation of the firm listed on the questionnaire below. This firm is currently being considered for a construction contract with the

Department of Veterans Affairs, Network Contracting Office (NCO) 17.

Your prompt attention to this questionnaire will be greatly appreciated. Please submit completed questionnaire via e-mail to cassandra.king@va.gov NLT the date and time specified in the solicitation.

file:///C:/Users/vhactxDunlaW1/AppData/Local/Documents%20and%20Settings/vhapugsantim/Local%20Settings/Airfield%20IDIQ%202009/Pre%20Award/far/Far02.doc%23T2101 file:///C:/Users/vhactxDunlaW1/AppData/Local/Documents%20and%20Settings/vhapugsantim/Local%20Settings/Airfield%20IDIQ%202009/Pre%20Award/far/FAR03.DOC%23b3104 mailto:cassandra.king@va.gov VHACTXKingC Cross-Out

ATTACHMENT 2

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: (to be completed by the Offeror)

Contractor’s Name: Telephone Number:

Contract Number: Tel/Fax Number:

Point of Contact (POC):

Address:

POC e-mail address: _______________________

Project Title and Brief Description of Work:

Contract Number: Dollar Amount: $

Contract Performance Period:

Contractor performed as the: Prime Contractor Sub-Contractor

B. RESPONDENT INFORMATION:

Name of Respondent: Title:

Address:

Telephone Number:

Email Address:

C. E-MAIL COMPLETED SURVEY FORM TO: cassandra.king@va.gov.

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE

EXPLANATION FOR ANY RATINGS OF M or U.

E: Exceptional: Performance meets contractual requirements with many exceeded to the Government’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

S: Satisfactory: Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

M: Marginal: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U: Unsatisfactory: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N: Neutral: Performance was not observed or not applicable to the current effort being reported against.

Place an “X” in the appropriate rating letter using the definitions matrix above.

The Contractor:

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

E _____ S _____ M _____ U _____ N _____

2. Provided adequate project supervision.

E _____ S _____ M _____ U _____ N _____

3. Complied with all Federal and locals laws including OSHA, EPA, etc.

E _____ S _____ M _____ U _____ N _____

4. Provided effective inspection procedures which resulted in a quality finished project.

E _____ S _____ M _____ U _____ N _____

5. Corrected deficiencies in timely manner.

E _____ S _____ M _____ U _____ N _____

6. Provided timely resolution of contract discrepancies.

E _____ S _____ M _____ U _____ N _____

7. Identified problems as they occurred/ Suggested alternative approaches to problems.

E _____ S _____ M _____ U _____ N _____ mailto:cassandra.king@va.gov

8. Displayed initiative to solve problems.

E _____ S _____ M _____ U _____ N _____

9. Developed realistic progress schedules.

E _____ S _____ M _____ U _____ N _____

10. Was responsive to contract changes.

E _____ S _____ M _____ U _____ N _____

11. Provided accurate, and complete records E _____ S _____ M _____ U _____ N _____

12. Complied with standards of wood workmanship

E _____ S _____ M _____ U _____ N _____

13. Paid subcontractors/suppliers in a timely manner.

E _____ S _____ M _____ U _____ N _____

14. Communicated with Government personnel to keep the project on schedule or minimize delays

E _____ S _____ M _____ U _____ N _____

15. Was diligent in forecasting and controlling cost.

E _____ S _____ M _____ U _____ N _____

16. Provided timely and accurate billing.

E _____ S _____ M _____ U _____ N _____

17. Submitted reasonable priced change proposals.

E _____ S _____ M _____ U _____ N _____

18. How would you rate the contractor's overall performance?

E _____ S _____ M _____ U _____ N _____

19. Did you ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

Yes _____ No _____

20. Would you award another contract to this contractor? If not, explain in “remarks

Yes _____ No _____

CONTRACTOR’S NAME: ______________________________________

CONTRACT NUMBER: ________________________________________

Remarks: