Past Performance Questionnaire.pdf

THIS PROPOSAL PACKAGE IS FOR THE GALLUP FIRE ALARM UPGRADE

PBS Past Performance Questionnaire, tailored for 47PH00623R0011 December 2022 FOR OFFICIAL USE ONLY SOURCE SELECTION SENSITIVE INFORMATION, see FAR 3.104 and 2.101

PBS PAST PERFORMANCE QUESTIONNAIRE

CONTRACT INFORMATION (Contractor/Offeror to complete Blocks 1-4)

2. GENERAL WORK INFORMATION

3. CONTRACT INFORMATION

Contract / BPA Number:

Delivery / Task Order / Call Number (if applicable):

Award Date (mm/dd/yy):

Originally Scheduled Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

4. PROJECT DESCRIPTION (check all applicable)

Other _____________ Major Subcontractor Prime Contractor Work performed as:

Other (Please explain) Cost Reimbursement Firm Fixed Price Contract Type:

Contract/Project Title:

Contract Location:

1. CONTRACTOR/OFFEROR INFORMATION

Firm Name:

Address:

Phone Number: UEID Number:

Contact Name:

Email Address: Contact Phone Number:

INSTRUCTIONS FOR CLIENTS COMPLETING THIS QUESTIONNAIRE: PBS requires the Client to email the completed questionnaire directly to the Contracting Officer, Brenna.Lanphear@gsa.gov and Contract Specialist Kevin.Mack@gsa.gov, no later than Friday, January 20, 2023, 4:00 p.m Central Time. PBS will not accept completed questionnaires sent from the Offeror. Handwritten responses are sufficient. All respondents will be contacted personally to verify their submission. The government reserves the right to verify any and all information on this form.

The Client’s signature is confirmation allowing the General Services Administration to use the information contained herein as source selection information.

If a subcontractor, who was the prime (Name/Phone #):

Project involved: □ Occupied building □ Non-occupied building □ Multi-Story

Tasks involved: □ Architectural □ Electrical □ Fire Alarm Replacement/Installation

□ Fire Sprinkler Installation/Alteration □ Elevator Replacement/Installation

□ Telecommunications

Brief Description of Project:

TO BE COMPLETED BY CLIENT

CLIENT INFORMATION

Client Point of Contact Information Name:

Title:

Phone Number:

Email:

Address:

Describe your role in the project:

I confirm that the contract information provided on the first page is correct and complete. (Correct 1st page if necessary)

Client’s Signature: Date questionnaire was completed:

Instructions: Select the adjective rating that best reflects your evaluation of the contractor’s performance. Please briefly explain any score of Unsatisfactory or Marginal in the comments section.

The contractor…

1. QUALITY U M S VG E N U

Provided professional quality work and the finished work compared favorably to the original intent of the project.

Displayed initiative to identify and correct problems or mistakes as they occurred, and demonstrated consideration for client/tenant concerns (cleanliness, noise, schedule coordination, etc).

2. SCHEDULE/TIMELINESS OF PERFORMANCE U M S VG E N

Developed and met realistic progress schedules, managed schedule variances to remain on time, and submitted deliverables on time.

3. MANAGEMENT/ PERSONNEL/LABOR U M S VG E N

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

Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel and subcontractors during the contract period, with limited turnover that did not negatively affect quality or schedule.

4. SAFETY/SECURITY U M S VG E N

Maintained an environment of safety, adheres to its approved safety plan, and responded to safety issues. Maintained construction site security.

5. GENERAL U M S VG E N

Was responsive to contract changes, and negotiated fair pricing for modifications.

6. CUSTOMER SATISFACTION U M S VG E N

How would you rate the contractor's overall performance, including timely resolution of warranty defects after construction was completed?

7. SUMMARY

Would you award another contract to this contractor? Yes No

See rating descriptions on page 4

Please provide an explanation of any rating of Unsatisfactory or Marginal (if applicable) and/or additional remarks.

COMMENTS SECTION

Please provide additional information below, and attach additional pages if necessary.

Use the following adjective ratings and definitions in your evaluation of the Contractor’s performance.

RATING DEFINITION NOTE

(E) Exceptional Performance met contractual requirements and exceeded many to the Government/Owner’s benefit. The contractual performance of the element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

An Exceptional rating is appropriate when the contractor successfully performed multiple significant events that exceeded requirements and were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone merits an Exceptional rating.

There should have been NO significant weaknesses identified.

(VG) Very Good Performance met contractual requirements and exceeded some to the Government’s/Owner’s benefit. The contractual performance of the element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

A Very Good rating is appropriate when the contractor successfully performed a significant event that exceeded requirements and was of benefit to the Government/Owner. There should have been NO significant weaknesses identified.

(S) Satisfactory Performance met all contractual requirements. The contractual performance of the element contained some minor problems for which corrective actions taken by the contractor were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified.

The contractor should not be given a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

(M) Marginal Performance did not meet some contractual requirements. The contractual performance of the element being evaluated reflected a serious problem for which the contractor did not identify corrective actions. The contractor's proposed actions were only marginally effective or were not fully implemented.

A Marginal rating is appropriate when one or two significant events occurred that the contractor had trouble overcoming, with negative effects.

(U) Unsatisfactory Performance did not meet most contractual requirements and recovery was not accomplished in a timely manner. The contractual performance of the element contained serious problem(s) for which the contractor's corrective actions were ineffective.

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming, with negative effects. A singular problem, however, could be of such serious magnitude that it alone merits an Unsatisfactory rating.

(N) Not Applicable No information or did not apply to your contract Rating will be neither positive nor negative.