Attachment_06_-_Past_Performance_Questionnaire.pdf

Granite Basin Turnaround Road Solicitation AG-8191-S-15-0001

SOURCE SELECTION SENSITIVE WHEN COMPLETED

**NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS**

PAST PERFORMANCE QUESTIONNAIRE

US Department of Agriculture, US Forest Service, Region 3 Prescott National Forest is considering the firm listed below. Your comments would be appreciated regarding this firm’s past performance.

CONTRACT INFORMATION (Evaluated Contractor to complete this section)

Name and Address of Firm Being Evaluated:

Work Performed as: ____ Prime Contractor ____Subcontractor Percent of Project Work Performed _____% Description of the Work Performed _____________________________________________________

Contract No.: Type of Contract: _ Project Title: __________ Date of Award: _ Completion Date: _ Location:

Initial Amount: Final Amount:

CLIENT INFORMATION (Client to complete this section)

Name of Evaluator:

Company/Agency Name:

Address:

Phone Number:

Email Address:

Position Held or Function in Relation to Project:__________________________________________________

Signature___________________________________________ Date________________________________

RATINGS: If the rating is “Unacceptable”, please provide additional information in the Remarks section of this form. “E” Excellent Performance greatly exceeded the contract requirements.

“VG” Very Good Performance exceeded the contract requirements.

“S” Satisfactory Performance met the contract requirements.

“M” Marginal Performance met the minimum contract requirements but some material aspects of the contractor’s performance were less than satisfactory.

“U” Unsatisfactory Performance was poor and/or did not satisfy contract requirements.

“N/A” Not Applicable

Please circle the appropriate rating and provide any supporting information for the following:

1. QUALITY:

a) Level of quality of workmanship or performance related to this project E V G S M U

b) Adequacy/effectiveness of quality control E V G S M U

c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

E V G S M U

Granite Basin Turnaround Road Solicitation AG-8191-S-15-0001

Contractor being evaluated______________________________________________ Client: _______________________________________________________________

Email this questionnaire to: jdutcher@fs.fed.us , Joni Dutcher, USDA Forest Service, no later than November 20, 2014.

2. SCHEDULE/TIMELINESS OF PERFORMANCE

a) Timeliness of submittals, reports, and other documents E V G S M U N/A

b) Compliance with work progress schedule E V G S M U N/A

c) Ability to complete work within contract time allowed E V G S M U

3. CUSTOMER SATISFACTION

a) To what extent were the end users satisfied with the project E V G S M U

b) Contractor was reasonable and cooperative in dealing with your staff Including the ability to successfully resolve disagreements/disputes

E V G S M U

c) To what extent was the contractor cooperative, businesslike, and concerned With the interests of the customer

E V G S M U

d) Responsiveness to customer’s requirements and concerns E V G S M U

e) Overall customer satisfaction E V G S M U

4. MANAGEMENT/PERSONNEL/LABOR

a) Effectiveness of on-site management, including management of suppliers, subcontractors and labor force

E V G S M U N/A

b) Ability to hire and retain a qualified workforce to this effort E V G S M U N/A

c) Knowledge/expertise demonstrated by contractor personnel E V G S M U

d) Effectiveness of overall management E V G S M U

5. COST/FINANCIAL MANAGEMENT

a) Ability to meet terms and conditions within the contractually agreed price E V G S M U

b) Has there been any indication that the contractor has had any financial problems? (if Yes, explain below)

Yes No

6. SAFETY

a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan and respond to safety issues

E V G S M U

7. GENERAL

a) Ability to successfully respond to emergency and/or surge situations

(including notifying COR, PM, or Contracting Officer in a timely manner regarding urgent contractual issues)

E V G S M U N/A

b) Compliance with contractual terms/clauses E V G S M U

c) Would you hire or work with this firm again? (If No, explain below) Yes No

d) Was this contract partially or completely terminated for default or convenience or are there any pending terminations (if Yes, explain below) Yes No

e) In summary, provide an overall rating for this contractor E V G S M U

REMARKS:

mailto:nhoward@fs.fed.us%20,