Attachment 6 Past Performance Evaluation Questionnaire.docx
DOCX document 30 KB Posted
- Attached to
- Building 62 Renovation Federal contract opportunity
- Solicitation number
- 75F40122R00086
About this file
This document contains a past performance evaluation questionnaire for a federal contractor to submit references from previous clients on similar projects. The questionnaire requests detailed information on previous contracts including location of work, description of work, problems encountered and resolutions, contractor and subcontractor roles. References are asked to rate and comment on the contractor's timeliness, quality of work, business relations, cost control, and management of key personnel using a scale of outstanding to unsatisfactory. References also indicate their overall satisfaction working with the contractor and whether they would work with them again. The evaluator is asked to provide contact information and signature. An attached federal contract opportunity solicitation requests proposals for the renovation of Building 62. Offerors should see the solicitation documents for full details and Section L-11 for an upcoming site visit. The opportunity is issued by the Department of Health and Human Services Food and Drug Administration Office of Acquisition and Grant Services.
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Text version
PAST PERFORMANCE EVALUATION QUESTIONNAIRE
1. Contract Identification: (to be completed by offeror)
Offeror name and address, offeror point of contact name/title, telephone number, and e-mail address:
Reference (client) information: Agency/company name and address, agency point of contact name/title, telephone number and e-mail address, for/ to whom this questionnaire was submitted:
Location of Work: ____________________________________________________________________________________
Description of Work:
Relevance of the referenced contract to the current requirement: ____________________________________________________________________________________
Problems encountered in performance and corrective actions taken:
Company’s capacity served on the project, i.e., prime, subcontractor, key personnel. Construction Project Manager, and on-site construction superintendent (including any major subcontractors) serving as key personnel on the project:
Contract Information:
Contract number:
Contract type:
Period of performance:
Original contract amount:
Final contract amount:
Final completion date:
Reason for difference (if any) between original contract amount and final contract amount:
2. Agency/Company Identification: (to be completed by client)
Description of work performed and the contractor’s association with the project (prime, subcontractor, etc.)
3. Contractor Performance Ratings:
Please rate the Contractor’s performance by utilizing the rating and definition provided below; it is imperative that ratings be accompanied by supporting narrative (comments):
| Rating |
| Definition |
| Outstanding |
| Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective. |
| Above Average |
| Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| Satisfactory |
| Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| Marginal |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects 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. |
| Unsatisfactory |
| Performance does not meet significant contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective. |
A. Timeliness of Performance
1. To what extent did the contractor adhere to contract delivery schedules? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments:
2. To what extent did the contractor submit required reports and documentation in a timely manner? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments:
B. Quality of Work
1. To what extent were the contractor’s reports and documentation accurate and complete? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments:
2. To what extent was the contractor able to solve contract performance problems without extensive guidance from Company/Government counterparts? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments:
3. Did the contractor provide a product or service that conformed to contract requirements, specifications, and standards of good workmanship? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments:
C. Business Relations
1. To what extent did the contractor commit adequate resources to the contract in a timely fashion in order to meet the requirements and to successfully solve problems? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments:
2. To what extent did the contractor submit change orders and other required proposals in a timely manner? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments: __________________________________________________________________________
3. To what extent did the contractor respond positively and promptly to technical directions, contract modifications, etc.? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments: __________________________________________________________________________
4. To what extent was the contractor effective in interfacing with the Company/Government’s staff? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments: __________________________________________________________________________
5. To what extent was the contractor committed to customer satisfaction and concerned for its customer’s interests? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ | ||
| Above Average | ☐ | ||
| Satisfactory | ☐ | ||
| Marginal | ☐ | ||
| Unsatisfactory | ☐ |
Comments: __________________________________________________________________________
D. Cost Control
1. How well did the firm submit accurate price information for change orders or task order proposals? (Ratings Must Be Supported by Comments
| Outstanding | ☐ | ||
| Above Average | ☐ | ||
| Satisfactory | ☐ | ||
| Marginal | ☐ | ||
| Unsatisfactory | ☐ |
Comments:
2. Did the Contractor initiate unwarranted change orders or change order requests? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ | ||
| Above Average | ☐ | ||
| Satisfactory | ☐ | ||
| Marginal | ☐ | ||
| Unsatisfactory | ☐ |
Comments:
E. Management of Key Personnel
1. Did the contractor use personnel with the appropriate skills and expertise to fulfill the requirements of the contract? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ |
| Above Average | ☐ |
| Satisfactory | ☐ |
| Marginal | ☐ |
| Unsatisfactory | ☐ |
Comments:
2. Did the contractor retain the necessary skilled personnel and maintain a low turnover rate? (Ratings Must Be Supported by Comments)
| Outstanding | ☐ | ||
| Above Average | ☐ | ||
| Satisfactory | ☐ | ||
| Marginal | ☐ | ||
| Unsatisfactory | ☐ |
Comments:
F. General
1. Were you satisfied overall with the Contractor’s performance? ☐ Yes ☐ No
Comments:
2. Would you do business with this contractor again? ☐ Yes ☐ No
Comments:
3. In summary, provide an overall rating for the work performed by this contractor. (Ratings Must Be Supported by Comments)
| Outstanding | ☐ | ||
| Above Average | ☐ | ||
| Satisfactory | ☐ | ||
| Marginal | ☐ | ||
| Unsatisfactory | ☐ |
Comments: ____________________________________________________________________________________
G. Evaluator Information:
Name (please print):
Title:
Work phone number (including area code): ____________________________________________________________________________________
FAX number (including area code): ____________________________________________________________________________________
E-Mail address:
Signature:
File details come from the government source that posted it. Updated .