Past-Performance-Questionnaire.doc

AG-0343-S-17-0016

ATTACHMENT #

PAST PERFORMANCE QUESTIONNAIRE

1. Information Provided in Response to RFP No.: AG-0343-S-17-0016

2. Offeror:

PART I: Contract Information

3. Customer Organization:

4. Reference Name and Title: (individual completing this questionnaire)

5. Contract Number:

6. Contract Type:

7. Contract Value:

8. Description of Work/Services:

9. Problems: (if problems encountered on this contract, explain corrective action taken)

Message to the reviewer: Your feedback is requested by US Forest to assist with establishing the performance history for the Contractor named below. Please e-mail the completed questionnaire(s) to: Estyn Kevitt at ekevitt@fs.fed.us. If you have any questions you can send an email or call at 208-765-7433.

Part II: Performance Assessment (to be completed by reviewer)

CODE

PERFORMANCE LEVEL

E

EXCEPTIONAL -

Performance exceeded many contractual requirements 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.

G

GOOD -

Performance exceeded some contractual requirements 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 effective..

S

SATISFACTORY -

Performance met contractual requirements. The contractual performance of the element or sub-element being assess was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were satisfactory.

M

MARGINAL -

Performance did not meet some contractual requirements. The contractual performance of the element or sub-elements 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 did 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 were ineffective.

N

NEUTRAL/NOT APPLICABLE OR UNKNOWN -

No performance record identifiable within the area of evaluation.

1. Quality of product or service - Management of the quality control program and quality of work:

E G S M U N

Comments:

2. Schedule - Complete administrative and physical construction activities in a timely manner, adequately schedule the work and met milestone dates, furnish updated project schedules on a timely basis, no assessment of liquidated damages:

E G S M U N

Comments:

3. Cost Control - Ability to complete contracts within budget (at or below); reasonableness of price change proposals submitted; providing current, accurate, and complete billings:

E G S M U N

Comments:

4. Management - Effective management, ability to manage projects involving subcontracts, working relationship with the contracting officer and technical representatives, reasonable/cooperative behavior, flexibility, effective contractor recommended solutions, businesslike concern for government's interests:

E G S M U N

Comments:

5. Utilization of Small Business - Complying with the Small Business Subcontracting Program:

Comments:

6. Regulatory Compliance - e.g failure to report in accordance with contract terms and conditions, late or nonpayment to subcontractors, trafficking violations, tax delinquency, defective cost or pricing data, terminations, suspension and debarments. Assess compliance with all terms and conditions in the contract relating to applicable regulations and codes:

Comments:

Source Selection Information – See FAR 2.101 and FAR 3.104 For Official Use Only