Past Performance Reference Questionnaire_12May2010.docx

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Two-Phase Design-Build PNW Juneau Forestry Science Lab Federal contract opportunity
Solicitation number
AG-0109-S-10-0004
Issued by
Department of Agriculture Forest Service R10-Alaska Region

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Past Performance Reference Check

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PAST PERFORMANCE REFERENCE CHECK AG-0109-S-010-0004 TWO-PHASE DESIGN-BUILD JUNEAU LAB

PROVIDE RESPONSES TO: kweidenbaugh@fs.fed.us

OR

FAX: (907) 743-9492 Response must be received prior to 2 June 2010 @ 2:00 pm (AK time)

A. Name of Evaluated Firm:

B. Information on Company/Person Providing Reference:

Name:_____________________________________________________________________________

Title:______________________________________________________________________________

Company:__________________________________________________________________________

Company Address:___________________________________________________________________

Telephone No:______________________________________________________________________

Title of Project:_____________________________________________________________________

Contract Number:___________________________________________________________________

Award Date:________________________Start Date:_______________________________________

Location of Contract Performance:______________________________________________________

Completion Date or % Complete: Planned:_______________Actual:__________________________

Length of Time Contractor employed:___________________________________________________

Contract Award Amount:_________________________Actual Cost:__________________________

Type of Space/Building:______________________________________________________________

Complexity of Work: High________Moderate___________Routine___________

Type of Contract:___________________________________________________________________

Actual Sq. Ft. in Project_________________

Number of Stories in Building____________

New Construction: Yes_____ No_______
Addition: Yes__________ No_________
Renovation: Yes________ No__________
Environmental Considerations: Yes_______ No________
Cultural Considerations: Yes________ No__________
LEEDS Certified: Yes_______ No________What Level Certification:_________
Remote Site: Yes__________ No___________
Extreme Weather: Yes______ No__________ If Yes, what kind:_____________

C.

Questions: (Some questions may not apply to your contract) Meaning of Numbers: 1=Unacceptable, 2=Poor, 3=Acceptable, 4=Good, 5=Excellent When numbers are given after a question, please circle the one that best applies.

1. What was the actual work performed by the Contractor?___________________________________

2. How well did the prime Contractor coordinate the work of consultants/subcontractors/supplies/labor forces?

1 2 3 4 5

Comments:_________________________________________________________________________

3. How responsive was the Contractor in administrative areas (e.g. processing necessary paperwork)? Were the Contractor’s reports and documentation accurate, complete and submitted in a timely manner?

1 2 3 4 5

4. Did the Contractor complete the project within the original contract schedule and budget? If not, explain. Was it due to factors within/beyond their control?

1 2 3 4 5

Evaluator Initials___________ 5.

Did the Contractor promote a cooperative relationship with the Owner, Project Manager and Contracting Officer and did they participate as a full partner in the project development team?

1 2 3 4 5

6. Were the number of and final price of change orders reasonable for the size and type of the project? What percentage of the change orders was initiated by the contractor? If design/build, were the only changes initiated by the Owner?

1 2 3 4 5

7. Did the Contractor submit an excessive number of RFI’s or submit frivolous RFT’s resulting in change order requests? Yes________ No_________

1 2 3 4 5

8. Was the Contractor able to implement changes smoothly without creating new problems?

1 2 3 4 5

Evaluator Initials________

9.

How would you describe the work quality? Please rate the Contractor’s overall performance? Was the Owner satisfied with the product of the Contractor’s efforts?

1 2 3 4 5

10. Were the Contractor’s design phase cost estimates accurate? Yes_____ No_____ If not, how much more/less was the final project result?

11. Did the Contractor’s review of design documents eliminate a significant portion of design and construction conflicts and/or problems during the construction phase? Yes________ No__________

12. Did the Contractor readily address ripple effect, such as time extensions, on change order proposals? Yes______ No_______

13. Were there any serious accidents or numerous minor accidents on this job? If so, how much time was lost due to those accidents? What kind of safety program did the Contractor have? Did the Contractor assign anyone to monitor safety full time? Did the Contractor actively work to prevent accidents? If so, how? If emergencies occurred, how did the Contractor respond?

1 2 3 4 5

Evaluator Initials______ 14.

Were there any labor problems? Did the project include the use of Small Business, Small Disadvantaged Business, Woman Owned, Veteran Owned or Service Disabled Veteran Owned, Small Business subcontractors? If so, how accurate was the Contractor’s proposed small business subcontracting goals with the actual performance.

1 2 3 4 5

15. Was the Alternative Disputes Resolution (ADR) process used on this project? How would you rate this firm’s ability to resolve disputes?

1 2 3 4 5

16. Please rate the Contractor’s performance in complying with contract requirements, quality achieved and overall technical expertise demonstrated.

1 2 3 4 5

17. For Designers, Architect/Engineers only, please rate the design ability of the Contractor.

1 2 3 4 5

Evaluator Initials:________ 18.

For Designers, Architect/Engineers only, were any construction problems precipitated by poor design, planning or mistakes made by the Contractor? Yes_______ No_________

19. Given the opportunity, would you use this Contractor again? Yes____No____Maybe______

20. Are you aware of any other projects performed by this Contractor in the past three years? If so, please list. You may also use this space for any other comments you may have.

Evaluator’s Signature:_______________________________________Date:___________________

When completed, please email signed questionnaire to kweidenbaugh@fs.fed.us or fax to (907) 743-9492. *Include a cover sheet when submitting via fax.

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