Attachment 5 - Contractor Past Performance Questionnaire.pdf

Solicitation No. 127EAX21R0004 Roads Construction IDIQ – Coconino & Kaibab NFs Attachment 5

Contractor Past Performance Inquiry

SOURCE SELECTION INFORMATION/CONFIDENTIAL

Dear Customer:

Our firm has submitted a proposal to the USDA Forest Service, Region 3, Southwest Zone. 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 Administrative Contracting Officer: Michael Carico Email Address: Michael.carico@usda.gov NO LATER THAN 08/12/2021

DO NOT RETURN THIS FORM TO OUR COMPANY

Contractor Name:

Address:

Contract or Order No.

Total Value of Contract:

Liquidated Damages Assessed:

Contract Award Date:

Final Completion Date:

Name of person completing this form:

Phone Number:

Name of Company or Government Agency:

Description of work this company performed:

mailto:Michael.carico@usda.gov

RATINGS - Summarize contractor performance and check the number that corresponds to the rating for each category.

RATING DEFINITION

E = Exceptional Performance exceeded what was required by the contract VG = Very Good Performance met all the requirements of the contract S = Satisfactory Contractor met most (essentially all) of the requirements of the contract M = Marginal Contractor met some of the requirements of the contract however changes to the contractor’s processes were necessary to achieve contract requirements

U = Unsatisfactory Contractor failed to meet requirements of the contract N/A = Not Applicable Question did not apply to the contract performed for your firm.

QUALITY AND TIMELINESS

How well did the contractor manage the quality of work?

How well did the contractor identify and correct deficient work?

Were submittals, testing, certifications, and final drawings (as-builts) completed accurately and timely?

Was work performed as scheduled?

Were delays resolved quickly and to both parties satisfaction?

MANAGEMENT AND BUSINESS RELATIONS

Did the contractor provide adequate oversight to sub-contractors, suppliers, employees?

Did the contractor maintain a good relationship with the owner, contracting agency, and management personnel?

If there were change orders, was the contractor reasonable in defining scope of change and controlling cost?

Did the contractor provide adequate work force (number and skills) for work being performed?

What percentage of the work was sub-contracted?

Comments:

COMPLIANCE WITH LABOR AND SAFETY STANDARDS

Did the contractor comply with labor laws incorporated into contract?

If there were problems, how well were they addressed and resolved?

Was a safety plan required? If so how well did the contractor follow the plan?

Were there hazards at the work site that required continual oversight and if so did the contract initiate corrections of safety hazards at the work site?

CUSTOMER SATISFACTION

Would you recommend the selection of this contractor again?