Atch 5-Perf Questionnaire.pdf

140P5421R0008 Attachment 5

N/A=NOT APPLICABLE U=UNSATISFACTORY M=MARGINAL S=SATISFACTORY VG=VERY GOOD E=EXCEPTIONAL

Page 1 of 2 Pages

PERFORMANCE QUESTIONNAIRE

For use in Solicitation # 140P5421R0008, Prep/Paint Exterior of Building-CUIS

(This questionnaire, when completed, shall not be disclosed to anyone outside the Government)

Contractor: Contract#: ________________________________________

Prime or Sub? ________ Contract Value at Award: $ ____________ Final Contract Value: $ ______________________

Contract Type: _______________________ Description of Service: _

Period of Performance: __________________________________ Date Questionnaire Completed: ________________

PLEASE FILL IN THE FOLLOWING RESPONDENT INFORMATION:

Name of Evaluator: ___________________________________ Organization: __________________________________

Phone #: ____________________ Fax #: ____________________ Email: ____________________________________

Position Title: _____________________________ Dates of Involvement in Contract: _____________________________ When responding, circle the corresponding letter (using the key at the bottom of the page) which most accurately describes the contractor’s performance or situation.

MANAGEMENT:

1. Management performance……………………………………………………….…. N/A U M S VG E

2. Effective Communication…………………………………………………………… N/A U M S VG E

3. Working relationship ………………………….……..……… N/A U M S VG E

4. Responsiveness to requirements……….……………………………… N/A U M S VG E

5. Ability to assimilate and incorporate changes in requirements and/or priority.…… N/A U M S VG E

6. Complied with gov’t or other regulations and industry standards…………….…… N/A U M S VG E

7. Willingness to resolve problems in:

(a) Scheduling Projects…………………………………………………….…….. N/A U M S VG E

(b) Quality Control……………………………………………………….…….… N/A U M S VG E

8. Ability to resolve problems in:

(a) Scheduling Projects………………………………………………….……..… N/A U M S VG E

(b) Quality Control………………………………………………………….….… N/A U M S VG E

9. To your knowledge, has contractor had any contracts terminated for default?

(If YES, please explain in “REMARKS”) ...…………………………………....…

….. YES NO

10. Has your organization ever elected to not exercise an option due to contractor’s poor performance? (If YES, please explain in “REMARKS”) ………

QUALITY

11. Were modifications issued due to contractor failure to meet technical requirements and/or delivery/cost schedules? (If YES, explain in “REMARKS”)

….... YES NO

12. Has a cure notice ever been issued? ...(If YES, explain in “REMARKS”)……… …….. ….... YES NO

13. Has a show-cause letter ever been issued? (If YES, explain in “REMARKS”)… …….. ….... YES NO

140P5421R0008 Attachment 5

N/A=NOT APPLICABLE U=UNSATISFACTORY M=MARGINAL S=SATISFACTORY VG=VERY GOOD E=EXCEPTIONAL

Page 2 of 2 Pages

COST

14. Ability to meet the terms of the contract within the contractually-agreed price(s).. N/A U M S VG E

15. Have contract concessions/changes ever been made due to contractor’s failure to accurately estimate costs? (If YES, explain in “REMARKS”)………………..….

16. Were the proposed costs for new items and/or requests for equitable adjustments considered reasonable?

17. Have there been any disputes/claims relative to the contract? (If YES, explain in

“REMARKS”)………………………………………………………………..……

18. Was the Contractor able to provide current, accurate and complete billing?........... …….. ….. YES NO

GENERAL

19. Contractor’s Overall Cooperation...………………………………………………. N/A U M S VG E

20. Contractor’s Overall Performance…………………………….…………………... N/A U M S VG E

21. Did the Contractor meet contract performance time and/or delivery schedule?...... …….. ….. YES NO

22. Would you award similar contracts to this contractor? (If NO, explain in

“REMARKS”)………………………………………………………………….….

23. What do you think was the Contractor’s strongest management attribute and why?

24. What was the Contractor’s weakest management attribute and why? Did the Contractor correct, or attempt to correct the weaknesses?

25. Remarks (areas having significance when considering this contractor for a similar contract; exceptional and unsatisfactory ratings):

THANK YOU IN ADVANCE FOR YOUR ASSISTANCE

Please email to Mary_Stefanos@nps.gov (specifying 140P5421R0008 in subject line) once completed mailto:Mary_Stefanos@nps.gov