Past_Performance.pdf

FOR OFFICIAL USE ONLY

(WHEN COMPLETED)

PERFORMANCE EVALUATION - CONSTRUCTION CONTRACTS

1. CONTRACT NUMBER

1. CONTRACTOR (Name, address, and ZIP code) 3. TYPE

OF

CONTRACT

(Check)

4. COMPLEXITY OF WORK

DIFFICULT ROUTINE

5. DESCRIPTION AND LOCATION OF WORK

6. FISCAL

DATA

7. SIGNIFICANT

DATES

a. AMOUNT OF BASIC

CONTRACT

b. TOTAL AMOUNT OF

MODIFICATION

c. LIQUIDATED DAMAGES

ASSESSED

d. NET AMOUNT PAID

CONTRACTOR

a. DATE OF AWARD b. ORIGINAL CONTRACT

COMPLETION DATE

c. REVISED CONTRACT

COMPLETION DATE

d. DATE WORK ACCEPTED

8. TYPE AND EXTENT OF SUBCONTRACTING

PART II PERFORMANCE EVALUATION OF CONTRACT (Check appropriate box)

9. PERFORMANCE ELEMENTS OUTSTANDING SATISFACTORY UNSATISFACTORY

a. QUALITY OF WORK

b. TIMELY PERFORMANCE

c. EFFECTIVENESS OF MANAGEMENT

d. COMPLIANCE WITH LABOR STANDARDS

e. COMPLIANCE WITH SAFETY STANDARDS

10. OVERALL EVALUATION

OUTSTANDING (Explain in Item 13, on reverse) SATISFACTORY UNSATISFACTORY (Explain in Item 14, on reverse)

11. EVALUATED BY

a. ORGANIZATION (Type or print)

B. NAME AND TITLE (Type or print) C. SIGNATURE d. DATE

12. EVALUATION REVIEWED BY

d. DATEC. SIGNATUREB. NAME AND TITLE (Type or print)

a. ORGANIZATION (Type or print)

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is usable

FOR OFFICIAL USE ONLY

(When completed)

STANDARD FORM 1420 (10-83)

Prescribed by GSA FAR (48 CFR) 53.236-1(b)

A. ADVERTISED

B. NEGOTIATED

CPFF

FIRM

FIXED

PRICE

OTHER

(Specify)

13. REMARKS ON OUTSTANDING PERFORMANCE - AS INDICATED BY THE CONTRACTOR'S PERFORMANCE ON THIS CONTRACT. IF YOU CONSIDER THE CONTRACTOR TO BE OUTSTANDING, SET FORTH FACTUAL DATA SUPPORTING THIS OBSERVATION. THESE DATA MUST BE IN SUFFICIENT DETAIL TO ASSIST CONTRACTING OFFICERS IN SELECTING CONTRACTORS THAT HAVE DEMONSTRATED OUTSTANDING QUALITY OF WORK AND RELIABILITY. (Continue separate sheet, if needed.)

14. EXPLANATION OF UNSATISFACTORY EVALUATION. FOR EACH UNSATISFACTORY ELEMENT, PROVIDED FACTS CONCERNING SPECIFIC EVENTS OR ACTIONS TO JUSTIFY THE EVALUATION (e.g., extent of Government inspection required, rework required, subcontracting, cooperation of contractor, quality of workmen and adequacy of equipment). THESE DATA MUST BE IN SUFFICIENT DETAIL TO ASSIST CONTRACTING OFFICERS IN DETERMINING THE CONTRACTOR'S RESPONSIBILITY.

(Continue on separate sheet, if needed.)

FOR OFFICIAL USE ONLY

(When completed)

FOR OFFICIAL USE ONLY

(When completed)

STANDARD FORM 1420 (10-83) BACK