Past Performance Form Questionaires.docx

SOURCE SELECTION INFORMATION/CONFIDENTIAL

Dear Customer:

Our firm has submitted a proposal to the USDA Forest Service, Region 3, Western Zone AQM. In accordance with the Federal Acquisition Regulations (FAR), they will evaluate our firm’s past performance. Your firm has been listed as a reference for work previously performed.

Your candid response to the attached survey will assist the evaluation team in this process and your participation in this evaluation is greatly appreciated. Please complete the enclosed survey as thoroughly as possible. General information regarding the responses may be released to the Offeror; the FAR prohibits the release of names providing the responses. Complete confidentiality will be maintained.

Please send the completed form to the address below to arrive NO LATER THAN 07/31/2012:

USDA Forest Service R3 Western Zone AQM 2324 E. McDowell Rd.

Phoenix, AZ 85006-2440 Attn: Carl Henderson

Or email it to: carlhenderson@fs.fed.us

DO NOT RETURN THIS FORM TO OUR COMPANY

SOURCE SELECTION INFORMATION/CONFIDENTIAL

PAST PERFORMANCE QUESTIONNAIRE

3. Contractor Address:

4. Contract Type: __Firm Fixed Price ____Cost Reimbursement ___ Other (Please Specify)

5. Agency Name:

6. Agency POC/Phone/Fax:

7. Period of Performance:

8. Dollar Amount of Award:

9. Title of Contract:

10. Description of Contract Service:

11. Complexity of Work: Difficult: ____________ Routine: ____________

NOTE: Please use adjectival ratings from attached sheet.

a. Quality of Services

b. Personnel

c. Subcontractor Mgmt

d. Business Relations

e. Timeliness of Performance

f. Customer Satisfaction

g. Cost/Budget Control

15. Would you select this firm again? Please explain. (Attach additional sheet if necessary.)

PAST PERFORMANCE RATING GUIDELINES

Summarize Contractor Performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Poor, Fair, Good, and Excellent. Use the following instructions as guidance in making these evaluations. Note: There is no corresponding guidance for “Customer Satisfaction”. Please use the comments area on the preceding form to justify the rating given “Customer Satisfaction.”

Personnel/Service

-Compliance w/contract requirements -Accuracy of reports -Appropriateness of personnel -Technical excellence

Cost Control

-Within budget -Current, accurate, complete billings -Relationship of negotiated costs to actual -Cost efficiencies -Change orders issued Timeliness of Performance

-Met interim milestones -Reliable -Responsive to technical direction -Completed on time Business Relations/Sub Contractor Mgmt

-Effective Mgmt -Businesslike correspondence -Responsive to contract reqmnts -Prompt notification of problems -Reasonable/ cooperative -Flexible -Pro-active -Effective SB/SDB Subcontract Program

are comprising the achievement of contract reqmnts

require major agency resources to ensure achievement of contract reqmnts

achievement of contract reqmnts

do not impact achievement of contract reqmnts Cost issues do not impact achievement of contract reqmnts