OwnerPastPerformanceSurvey 1 .docx

OWNER/CLIENT PAST PERFORMANCE SURVEY (optional use) Please completed and submit for Jim Brown Culvert Replacement

CONTRACTOR (Name of Offeror):___________________________________________________

Address:________________________________________________________________________________

The USDA Forest Service uses “Past Performance” information to evaluate contractor potential for quality performance. The term refers to a firm’s record of: Conforming to contract requirements; Meeting standards of good workmanship; Forecasting and controlling costs; Adherence to contract schedules, including the administrative aspects of performance; to its history of reasonable and cooperative behavior and commitment to customer satisfaction; and the firm’s general business-like concern for the interests of the customer.

These answers relate to the work performed under the following Project, Dated ___/___/____ to __/___/____

Name / Number, Dollar value: ___________________________________________ $______________

Location of project:_______________________________________________________ _____

Description or Type of Work___________________________________________________________ DEFINITION of rating levels:

Outstanding: The contractor has demonstrated an outstanding performance level in any of the categories that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as "Excellent". Very High Confidence in this contractor.

Excellent: There are no problems. Contractor tends to make an extra effort to make operations and performance run smoothly. Significant Confidence in this contractor.

Good: Overall compliance reasonably meets objectives and does not impact achievement of contract requirements. Reasonable level of Confidence in this contractor.

Fair: Overall compliance requires Agency resources to ensure achievement of contract requirements. Some Confidence in this contractor.

Poor: Overall compliance requires major Agency resources to ensure achievement of contract requirements. Little to No Confidence in this contractor.

Unsatisfactory: Nonconformances are jeopardizing the achievement of contract requirements, despite use of Agency resources. No Confidence in this contractor.

How would you rate the Overall Performance of this Contractor on the subject project?

Outstanding Excellent Good Fair Poor Unsatisfactory

Quality of Products/Services/Construction Rating:______ Were quality products/services/construction received?

Did the end result meet expectations regarding quality?

Does the Contractor act proactively to avoid or resolve difficulties?

Did contactor staffing or organizational management ever present problems in performance or receipt of goods and services?

Describe the availability of key management and technical personnel and their support of the project.

Describe the effectiveness of contractor Quality Control. Was it proactive?

Comments:

Customer Satisfaction Rating:______ To what extent were the users satisfied with performance and completed products?

Was Contractor proactive in project management and relations in providing for customer Satisfaction?

Did the Contractor foster good working relations with you and with other entities and the public?

Did upper level management take sufficient interest in the project to ensure that the firm was meeting your expectations?

Business Relations Rating:______ Over project management (i.e. business relations with others).

Describe the working relationship of the Contractor and your organization and site representatives as well as the Contractor’s subcontractors.

Contractor’s communication with the owner/technical personnel and ability to resolve problems.

Was the contractor able to hire, train, subcontract and maintain a quality workforce?

Based upon your knowledge of the past performance and experience with this contractor, would you award them another contract?

Respondent / Evaluator Identification. Please complete the following – you may be contacted for additional information regarding the named contractor: Please use additional pages if needed.

Name: _____________________Title ___________________ Phone ____________ FAX _____________

Date:_________________ E-Mail: ______________________

Return to: Matthew E Markovich, CO, R1 IMAT (Idaho Montana Acquisition Team), 12730 Hwy 12, Orofino, ID 83544. Telephone (208) 476-8379, FAX (208) 476-8288.

AG-02RC-S-13-0019, Jim Brown Culvert Replacement