ATT_4__Past_Perf_Questionnaire.docx
DOCX document 34 KB Posted
- Attached to
- JILONA Shoreline Stabilization Federal contract opportunity
- Solicitation number
- 140L0624R0042
About this file
This document is a Past Performance Questionnaire related to the JILONA Shoreline Stabilization contract opportunity, Solicitation Number 140L0624R0042. The questionnaire requests information about the contractor's past performance on a prior contract, including details on the contract type, value, period of performance, scope of work, and the contractor's quality, schedule, pricing, management, and regulatory compliance. The reference is asked to provide an overall recommendation for the contractor's ability to perform on similar contracts. The completed questionnaire should be sent directly to the Contracting Officer and is not to be included in the offeror's proposal. The related federal contract opportunity is for construction services for a shoreline stabilization project, issued by the Department of the Interior Bureau of Land Management National Office.
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Text version
PAST PERFORMANCE QUESTIONNAIRE
140L0624R0042 – JILONA SHORELINE STABILIZATION
A. CONTRACTOR INFORMATION
| Company Name |
| Company |
| Street Address |
| Address |
| City |
| City |
| State |
| State |
| Zip Code |
| XXXXX |
| DUNS Number |
| XXXXXXX |
| Point of Contact |
| Name, Email, Phone |
B. CONTRACT INFORMATION
| Project Title |
| Title |
| Contract Number |
| XXXXXXXXXX |
| Contract Type |
| Firm Fixed Price / Time & Materials / Cost Reimbursable / Other |
| Awarded Contract Price |
| $X,XXX,XXX |
| Current / Final Price |
| $X,XXX,XXX |
| Contract Award Date |
| XX/XX/XXXX |
| Contract Completion Date |
| XX/XX/XXXX |
| Project Location |
| Street address, City, State |
| Client / Owner |
| Company |
| Brief description of the contract & work effort: |
| Scope of work description |
| Did this project include any marine construction? |
| Please respond yes or no. |
C. REFERENCE:
Name
Position / Title
Organization
Phone Number
Email Address
Signature
Date
D. EVALUATION
| Rating |
| Definition |
| Exceptional (EX) |
| Performance met contractual requirements and exceeded many to the owner’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
| Very Good (VG) |
| Performance met contractual requirements and exceeded some to the owner’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| Satisfactory (S) |
| Performance met contractual requirements. The element being assessed contained some minor problems for which corrective actions taken by the contractor were satisfactory. |
| Marginal (M) |
| Performance did not meet some contractual requirements. The element being assessed reflects a serious problem for which the contractor has not yet identified corrective action. |
| Unsatisfactory (U) |
| Performance did not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions were ineffective. |
Not Applicable (NA)
The element does not pertain to the subject project as a result of specific contract and/or project requirements.
| Evaluation Area |
| Rating |
Quality
Quality of workmanship (including subcontractors)?
Quality of and adherence to quality control plan?
Quality of informational and technical submittals?
Overall Quality Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Schedule & Time Management
Met project schedule milestones and/or deadlines?
Responded to owner requests in a timely manner?
Informational and technical submittals submitted timely?
Promptly addressed scheduling issues?
Overall Schedule & Time Management Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Pricing and Payments
Minimized additional costs when addressing differing & unforeseen site conditions?
Provided fair and reasonable pricing for contract modifications?
Submitted accurate and complete invoices?
Promptly paid subcontractors and suppliers?
Overall Pricing and Payment Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Management
General oversight by project manager and superintendent?
Coordination with and control of subcontractors?
Avoidance of accidents & safety violations?
Addressed location factors (especially remote locations)?
Maintained good working relationship with owner representatives?
Demonstrated flexibility, innovativeness and cooperation in resolving potential problems?
Overall Management Rating
Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):
Regulatory Compliance
Met building and life safety codes?
Met regulatory and contractual labor standards?
Overall Regulatory Compliance Rating
Overall Recommendation:
Given what I know today about the contractor's ability to perform in accordance with the contract’s most significant requirements, I would recommend them for similar contracts:
Overall Comments:
E. SUBMISSION INSTRUCTIONS:
The offeror shall complete Parts A & B and coordinate completion of Parts C & D with the respective reference. Completed Past Performance Questionnaires shall not be included in the offeror’s proposal and shall be sent directly to the Contracting Officer at jsteed@blm.gov.
The offeror is responsible for compiling and submitting completed past performance questionnaires in its proposal, though the Government may contact references to verify the veracity of provided information. References shall send completed past performance questionnaires to the Government.
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