Atch_5_-_Past_Performance_Evaluation_Form.pdf

PAST/PRESENT PERFORMANCE EVALUATION FORM

CONTRACTOR/FIRM BEING EVALUATED:

EVALUATOR INFORMATION

Contractor/Company Name:

Evaluator Name: Phone No.:

Evaluator Signature: Fax No.:

Contract Number/Title:

Type of Contract (Sealed Bid/RFP/Other):

Dollar Amount of Award: Dollar Amount at Completion:

Period of Performance: Percent Complete:

Scope of Contract Requirements/Location:

CODE PERFORMANCE LEVEL

O OUTSTANDING Contractor’s performance level far exceeds all contractual requirements.

E EXCELLENT Contractor’s performance level exceeds most contractual requirements with no other problems noted.

S SATISFACTORY Contractor’s performance level meets the minimum requirements of the Contract. No major problems exist and minor problems were quickly resolved.

P POOR Contractor’s performance level is in danger of or did not satisfy contractual requirements.

Please circle the appropriate letter for each item below and provide narrative explanation of your assessment, i.e. strengths/weaknesses that support the rating.

1. Contractor’s ability and performance in identification of potential contractual problems early, and advisement of the Government before the problems became delay, cost, or safety threatening.

O E S P

2. Contractor’s ability and performance in cooperating with the Government, i.e. timely submission progress schedules, change proposals, reports, submittals, good faith negotiations, realistic cost proposals, etc.

3. Contractor’s ability and performance in providing a realistic schedule and effectiveness in meeting established schedule.

4. Contractor’s performance in maintaining a full-time superintendent with sufficient authority to speak and act for the Contractor.

5. Superintendent’s performance in managing employees/subcontractors to keep the job moving on schedule; contractor’s performance in ordering equipment/materials for delivery within approved schedule period.

6. Contractor’s performance in providing timely resolution of punch list items.

7. Contractor’s performance in paying subcontractors/suppliers in a timely manner; invoices are timely with supporting documentation (progress/payment schedules, certification, payrolls).

8. Contractor’s ability to understand technical aspects of work and performance in interpreting contract intent without extensive intervention by the Government.

9. Contractor performed mechanical work, including workmanship, mechanical equipment, piping, and ductwork, and testing in accordance with the drawings, specifications, and appropriate codes.

10. Contractor’s performed electrical work, including workmanship, equipment, and testing in accordance with the drawings, specifications and appropriate codes.

11. Contractor’s ability and performance of computer control and instrumentation work in accordance with the specifications and appropriate codes.

12. Contractor’s ability to prevent damage to all aspects of new construction including structure, equipment, and casework prior to beneficial occupancy.

13. Safety violations/accidents? OSHA violations, personal injury? Please explain.

YES NO

14. Contractor followed required OSHA safety standards when working in confined spaces.

YES NO

15. Contractor’s performance in providing proper safety protection for workers when required.

16. Contractor’s performance in providing safety barriers, proper scaffolding, diamond plate over road holes, proper safety signage, proper lighting, etc. when required.