AttachmentV.doc

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Attached to
Grand Rapids Aquatics Lab Renovation Federal contract opportunity
Solicitation number
AG-63PX-S-07-0006
Issued by
Department of Agriculture Forest Service Research Service Northern Research Station

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Attachment V Past Performance Questionnaire

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Text version

AG-63PX-S-07-0006

Aquatics Lab Renovation Attachment V

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

SECTION A: CONTRACTOR INFORMATION

A. Contractor’s Name and Address: ________________________________________________

B. Point of Contact: ______________________________________________________________

C. Phone #: ____________________________________________________________________

D. Contract Number: ___________________ Contract Type: ____________________

E. Project Title: _________________________________________________________________

F. Period of Performance: _________________________________________________________

G. Brief Description/Scope of Services provided: _________________________________________

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

Signature of Authorized Contractor Representative Date

Printed Name and Title of Authorized Contractor Representative

SECTION B: RESPONDENT INFORMATION

A. Name:______________________________________

B. Position:____________________________________

C. Telephone Number:________________________ Fax Number: ________________________

D. Address:___________________________________

E. Relationship and Time Involved with Contractor:_____________________________________

F. Date Questionnaire Completed:_______________________________

E
VG
S
N
M
U
Excellent
Very Good
Satisfactory
Neutral
Marginal
Unsatisfactory

CONTRACT PERFORMANCE

1.
Working relationship with your Company
E
VG
S
N
M
U
2.
Did the contractor provide experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements? If , please explain.
3.
Exhibited k wledge of and compliance with government (or other) regulations and industry standards
E
VG
S
N
M
U
4.
Did the contractor provide and properly maintain operational equipment throughout the term of the contract? If , please explain.
5.
Did the contractor demonstrate the ability to hire, maintain, and replace, if necessary qualified personnel during the contract? If , please explain.
6.
Does the contractor provide timely and accurate records?
7.
How well did the contractor comply with Environmental, Safety, health and security requirements
E
VG
S
N
M
U
8
Would you award similar contracts to this contractor (If , Please explain in remarks)
9.
Contractor’s Overall Performance
E
VG
S
N
M
U

QUALITY OF SERVICE/CONTROL

1.
Contractor’s accomplishment in meeting the quality standards
E
VG
S
N
M
U
2.
Did the contractor provide an effective quality control plan or inspection procedures to meet contract requirements? If , please explain.
3.
Overall Quality of Service/Control
E
VG
S
N
M
U

TIMELINESS OF PERFORMANCE

1.
Was the job/contract started and completed on time?. If t, explain
2.
Did the contractor have a system or method to track progress on all work in progress?

REMARKS: If additional remarks are necessary, please attach an additional sheet.

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