Attachment 1 - Project Experience Questionnaire (SUBMIT WITH QUOTE).pdf

Project Experience Questionnaire Attachment 1

Unique Entity Identifier:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other (Explain)

Percent of project work performed:

If subcontractor, who was the prime (Name/Phone/Email:):

3.Contract Information

Delivery/Task Order Number (if applicable):Contract Number:

Contract Title:

Contract Location:

Contract Period of Performance :

Date: Contract Price:

4. Project Description: Describe in detail how this project is relevant to this requirement. Include a description of work performed and explain how the work is relevant (i.e. similar services and personnel qualifications, etc.) Attach additional pages if necessary.

Part B: CLIENT INFORMATION (Client to complete Part B, questions 5-7 and page 2 of this Questionnaire)

5. Client Information Company/Agency Name:

Name (individual completing this form):

Title:

Phone Number:

Email Address:

6. Describe the client’s role in the project:

7. Client’s Signature: __________________________________ Date: __________________________________

Clients are encouraged to submit questionnaires directly to the offeror. However, questionnaires may be submitted directly to the Government POC (Lisa Draves at lisa.a.draves@usda.gov.) The Government reserves the right to verify any and all information on this form.

Part A: CONTRACT INFORMATION (Quoter to complete Part A, questions 1-4)

1. Quoter Information Company Name:

Address:

Point of Contact:

Phone Number:

Email Address:

Project Experience Questionnaire (Part B continued)

RATING SCALE:

(E) Exceptional Performance met contractual requirements and exceeded many to the Government/Owner’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

(VG) Very Good Performance met contractual requirements and exceeded some of the Government's/Owner's benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

(S) Satisfactory Performance met minimum contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

(M) Marginal Performance did not meet some contractual requirements. The contractual performance reflected a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented.

(U) Unsatisfactory Performance did not meet most contractual requirements and recovery was not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

(N) Not applicable No information or did not apply to your contract.

TO BE COMPLETED BY CLIENT: Using the definitions above, please circle the adjective rating which best reflects your evaluation of the contractor's performance.

1. Rate the contractor's compliance with contractual requirements E VG S M U N

2. Rate the contractor's ability to identify and correct non-compliance issues E VG S M U N

3. Rate the contractor's overall business relations E VG S M U N

4. Rate the contractor's overall conformance to schedule E VG S M U N

5. Rate the contractor's ability to provide a qualified workforce to this effort E VG S M U N

6. Rate the contractor's overall quality of service E VG S M U N

7. E VG S M U NRate the contractor's ability to manage and supervise personnel/crews (includes management of subcontractors)

8. Ability to manage and supervise services performed at the work location E VG S M U N

12. Additional Remarks (attach additional pages if necessary)