J.12_-_Contractor's_References.docx

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IDIQ - Forestwide Timber Marking and Cruising
Solicitation number
AG-3434-S-13-0005
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J.12 Contractors References Questionnaire

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Instructions: This form may be used to document your past performance. Forward this form to your reference(s). Request they complete the form and return it to the Contracting Officer before the offer due date and time.

REFERENCES QUESTIONAIRE

SECTION A: CONTRACTOR INFORMATION

A. Contractor’s Name and Address:

B. Point of Contact C. Phone Number:

D. Contract Number E. Project Title:

F. Period of Performance:

G. Brief Description/ Scope of Services:

H. Authorization is hereby granted to provide the information requested in SECTION B of this questionnaire:

Signature of Authorized Offeror Representative Date

Printed Name and Title of Authorized Offeror Representative

REFERENCE/RESPONDENT INFORMATION:

A. Name:

B. Position C. Phone # D. Address:

E. Relationship:

F. Date Questionnaire Completed:

ATTACHMENT J-12

AG-3434-S-13-0005

PRESENT/PAST PERFORMANCE QUESTIONAIRE

RATING SCALE

E
S
M
U
N
Exceptional
Satisfactory
Marginal
Unacceptable
No Rating
ONE
CONTRACT PERFORMANCE
A
Working relationship with your company
E
S
M
U
N
B
Did the contractor provide experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements? If no, please explain
YES
NO
N/A
C
Exhibited knowledge of and compliance with government (or other) regulations and industry standards?
E
S
M
U
N
D
Did the contractor provide and properly maintain operational equipment throughout the term of the contract? If no, please explain
YES
NO
N/A
E
Did the contractor demonstrate the ability to hire, maintain, and replace (if necessary) qualified personnel during the contract period? If no, please explain.
YES
NO
N/A
F
Does the contractor provide timely and accurate reports?
YES
NO
N/A
G
How well did the contractor comply with environmental, safety, health and security requirements?
E
S
M
U
N
H
Would you award similar contracts to this contractor? If NO, please explain in remarks.
YES
NO
N/A
CONTRACTOR’S OVERALL PERFORMANCE
E
S
M
U
N
TWO
QUALITY OF SERVICE/CONTROL
A.
Contractor’s accomplishment in meeting the quality standards.
YES
NO
N/A
B.
Did the contractor provide an effective quality control plan or inspection procedures to meet contract requirements? If no, please explain.
YES
NO
N/A
CONTRACTOR’S OVERALL QUALITY OF SERVICE/CONTROL
E
S
M
U
N
THREE
TIMELINESS
A
Was the job/contract started and completed on time? If not please explain why
YES
NO
N/A
B
Did the contractor have a system or method to track all work in progress?
YES
NO
N/A
CONTRACTOR’S OVERALL TIMELINESS
E
S
M
U
N

CONTRACTOR’S OVERALL EVALUATION RATING

E
S
M
U
N

REMARKS: ________________________________________________________________________________________

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