ATTACHMENT 1 PAST PERFORMANCE QUESTIONNAIRE.docx

ATTACHMENT 2

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

Note: When completed this document is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

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, Solicitation # 36C25725R0010).

Your prompt attention to this questionnaire will be greatly appreciated. Please submit completed questionnaire via e-mail to RHONDA.RICHARDSON5@va.gov NLT the date and time specified in the solicitation. If you have any questions concerning this request, contact me directly if you have any questions or concerns.

Sincerely, Rhonda Richardson Contract Officer

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: ____________________________

C. E-MAIL COMPLETED SURVEY FORM TO: rhonda.richardson5@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.

CONTRACTOR’S NAME: _______________ CONTRACT NUMBER: _______________

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 _____

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: