Past Performance Inquiry Form.doc

Past Performance Inquiry Form

PAST PERFORMANCE INQUIRY FOR:

(Offeror’s Name)

Dear Customer:

Our firm has submitted a proposal to the USDA Forest Service, Northern Region. In accordance with the Federal Acquisition Regulations (FAR), they will evaluate our firm’s past performance. Your candid response to the attached survey will assist the evaluation team. Please complete the enclosed survey as thoroughly as possible and forward it to the Forest Service (DO NOT RETURN THIS FORM TO OUR COMPANY).

General information regarding the responses may be released to the Offeror; however, the FAR prohibits the release of names providing the responses. Complete confidentiality will be maintained.

Please send the completed form to the address below to arrive NO LATER THAN February 4, 2009:

USDA Forest Service

Western Montana Acquisition Zone

ATTN: Sue Beron

Building 24, Fort Missoula

Missoula, MT 59804

Or email it to: sberon@fs.fed.us

Contractor Name:

Address:

City, State, and Zip Code

Contract or Order No.:

Total Value of Contract:

Liquidated Damages Assessed:

Contract Award Date:

Final Completion Date:

Name of person completing this form:

Phone Number:

Name of Company or Government Agency:

Description of work:

SOURCE SELECTION INFORMATION/CONFIDENTIAL

RATINGS - Summarize Contractor performance and check the number that corresponds to the rating for each category.

QUALITY AND TIMELINESS

Rating

How well did the Contractor manage the quality of work?

How well did the Contractor identify and correct deficient work?

Were submittals, testing, certifications, and final drawings (as-built drawings) completed accurately and timely?

Was work performed as scheduled?

Were delays resolved quickly and to both parties’ satisfaction?

MANAGEMENT AND BUSINESS RELATIONS

Rating

Did the Contractor provide adequate oversight to Subcontractors, suppliers, and employees?

Did the Contractor maintain a good relationship with the owner, contracting agency, and management personnel?

If there were change orders, was the Contractor reasonable in defining scope of change and controlling cost?

Did the Contractor provide adequate work force (number and skills) for work being performed?

What percentage of the work was subcontracted?

COMPLIANCE WITH LABOR AND SAFETY STANDARDS

Rating

Did the Contractor comply with labor laws incorporated into contract?

If there were problems, how well were they addressed and resolved?

Was a safety plan required? If so, how well did the Contractor follow the plan?

Were there hazards at the worksite that required continual oversight and if so did the Contractor initiate corrections of safety hazards at the worksite?

Comments:

CUSTOMER SATISFACTION

Rating

Would you recommend the selection of this Contractor again?

Comments: