Att__2_Section_J_PPQ.pdf

Solicitation No. 140R2024R0002 Section J Attachment 2

LCR 1453.303-PRE 1415-39

Revised 09/02/05

SOURCE SELECTION SENSITIVE WHEN COMPLETED

***NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS***

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

U.S. Department of the Interior, Bureau of Reclamation, California Great Basin Region, Sacramento, CA, is considering the firm listed below. Your comments will be appreciated regarding this firm’s past performance.

Past Performance Information:

Name and Address of Firm Being Evaluated:______________________________________

Contract No.:__________________ Type of Contract: ____________________________ Project Title:___________________ Original Completion Date: _____________________ Date of Award:_________________ Actual Completion Date: _______________________ Location:______________________ Initial Contract Amount: ________________________ Initial Amount:__________________ Final Contract Amount: ________________________ Description:_________________________________________________________________

Evaluator: (The following information will assist in the analysis of the data.)

Name of Evaluator: ______________________________________

Company/Agency Name: ______________________________________

Address: ______________________________________

Phone Number: ______________________________________

Email Address: ______________________________________

Position Held or Function in Relation to Project: ______________________________________

Rating: If the rating is “Marginal” or “Unacceptable,” please provide additional information in the appropriate block or in the remarks section of this form.

“O” Outstanding Performance greatly exceeded the contract requirements.

“E” Excellent Performance exceeded the contract requirements.

“G” Good 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” Unacceptable Performance was poor and/or did not satisfy contract requirements.

Solicitation No. 140R2024R0002 Section J Attachment 2

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

1.

The relationship between the firm and client’s/customer’s contract team:

O E G M U

2.

The firm’s management and coordination of subcontractors/consultants:

3.

Overall corporate management, integrity, reasonableness and cooperative conduct:

4.

Timeliness and quality of reports, deliverables, and other required submittals and documents:

5.

The firm’s business integrity:

6.

Responsiveness to customer/client’s requirements:

7.

Ability to control costs and provide required work at reasonable total price:

8.

Contract Compliance:

9.

Change Management:

10.

Performance on technical submittals (Thorough, Complete, On-time):

11.

Compliance with safety standards and/or number of safety related incidents, code compliance, as applicable:

O E G M U N/A

12.

Performance in the development and execution of site-specific job hazard analyses (JHAs):

13.

Performance of rapid installation, removal, and relocation of coffer dams and slide gates:

14.

Performance fabricating and installing new leaf seats and rubber seals:

15.

Performance removing, refurbishing, and replacing slide gate leaves:

Solicitation No. 140R2024R0002 Section J Attachment 2

16.

Performance removing coatings and application of coatings for metal features in and around water control structures (including touch up repairs and protection during work):

17.

Performance documenting work on as-built drawings:

18.

Would you award another contract to the firm being evaluated? If no, please explain:

Yes No

19.

Was the customer satisfied with the end product? If no, please explain:

20.

Has the firm being evaluated been provided an opportunity to discuss or respond to any negative comments or performance ratings? If so, what were the results?

21.

Additional Remarks:

Continue on next sheet.

22. Overall rating for this firm: O E G M U

Printed Name of Evaluator Telephone Number of Evaluator

Signature of Evaluator Date

The questionnaire should be submitted to the Bureau of Reclamation by one of the following means.

Return attention to Matthew Thomas via email at mthomas@usbr.gov.

21.

Additional Remarks Continued:

mailto:mthomas@usbr.gov

Solicitation No. 140R2024R0002 Section J Attachment 2