Reference Check Form.doc

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Elevator Inspection Services in support of the Eastern Service Area (ESA)
Solicitation number
697DCK-19-R-00421
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PAST PERFORMANCE SURVEY

Reference from: _______________________

Contract Title ________________________

Contract Amount $______________________

Respond to the following on a scale of 1 to 5, 3 being average or acceptable, and 5 being excellent.

1. Did the contractor commit adequate resources in a timely fashion to the contract to meet the requirement?

1 2 3 4 5

2.

To what extent did the contractor respond positively and promptly to technical directions, contract change orders, etc.?

1 2 3 4 5

3. Was the contractor timely in following his Schedule of Work?

1 2 3 4 5

4. Was the contractor responsive to information requests, issues, or problems during the course of the contract?

1 2 3 4 5

5. Did the contractor demonstrate an ability to administer/ manage the contract, submit businesslike correspondence and adhere to the contract clauses/specifications and drawings?

1 2 3 4 5

6. Were required reports/submittals accurate and submitted in a timely fashion?

1 2 3 4 5

7. Did the contractor comply with all safety requirements?

1 2 3 4 5

8. Rate your level of satisfaction with the contractor’s overall quality of service?

1 2 3 4 5

Respond to the following Yes or No:

9. Were there any cure notices issued?

Yes_____No_____

10. Was contract completed within the scheduled performance time?

If no, describe the reason for delay.

11. Would you recommend this contractor?

12. Would you award another contract to this contractor?

Yes _____No_____

The following are for Federal contracts:

13. Were there any Labor Department investigations?

If yes, please describe reason and final outcome.

14. Were there any safety investigations/violations?

15. Was there a partial or complete termination for default or convenience?

16. Are there any pending terminations?

Yes_______No_____

17. What is/was the duration of the contract?___________________Calendar Days

18. Were there any performance issues regarding the contractor’s work?

If yes, please explain:

Additional comments:

FIRM:_________________________________________

NAME: ________________________________________

TITLE:__________________________________________

DATE:___________________________________________

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