Attachment 8 -Past Performance Questionnaire.docx
DOCX document 32 KB Posted
- Attached to
- DESIGN BUILD PAYSON RANGER DISTRICT HELI BASE Federal contract opportunity
- Solicitation number
- 12837120R0008
About this file
This document includes a past performance questionnaire and details of a federal contract opportunity for design and construction of a new heliport for the Payson Ranger District. The past performance questionnaire is to be completed by both the contractor being evaluated and a client to provide ratings and feedback on quality, schedule, customer satisfaction, management, cost, safety and overall performance on prior contracts. It must be returned by September 11, 2020. The related federal contract opportunity is solicitation number 12837120R0008 to provide design and construction services for a new Payson Ranger District heliport. Services required include field investigation and reporting, design, construction, earthwork, utilities, paving, concrete, carpentry, thermal and moisture protection, electrical, HVAC, plumbing, telecommunications, access control and lightning protection. The agency is the US Department of Agriculture Forest Service Southwestern Region.
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Text version
Payson Helibase Design Build Solicitation 12837120R0008
ATTACHMENT 8
SOURCE SELECTION SENSITIVE WHEN COMPLETED
**NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS**
PAST PERFORMANCE QUESTIONNAIRE
US Department of Agriculture, US Forest Service, Region 3 is considering the firm listed below. Your comments would be appreciated regarding this firm’s past performance.
CONTRACT INFORMATION (Evaluated Contractor to complete this section)
Name and Address of Firm Being Evaluated:
Work Performed as: ____ Prime Contractor ____Subcontractor Percent of Project Work Performed _____% Description of the Work Performed _____________________________________________________
| Contract No.: | Type of Contract: | _ Project Title: | __________ |
| Date of Award: | _ Completion Date: | _ Location: |
Initial Amount: Final Amount:
CLIENT INFORMATION (Client to complete this section)
Name of Evaluator:
Company/Agency Name:
Address:
Phone Number:
Email Address:
Position Held or Function in Relation to Project:__________________________________________________
Signature___________________________________________ Date________________________________
RATINGS: If the rating is “Unacceptable”, please provide additional information in the Remarks section of this form.
| “E” | Excellent | Performance greatly exceeded the contract requirements. “VG” | Very Good | Performance exceeded the contract requirements. | |
| “S” | Satisfactory | 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” | Unsatisfactory | Performance was poor and/or did not satisfy contract requirements. |
“N/A” Not Applicable
Please circle the appropriate rating and provide any supporting information for the following:
1. QUALITY:
| a) |
| Level of quality of workmanship or performance related to this project |
| E VG S M U |
| b) |
| Adequacy/effectiveness of quality control |
| E VG S M U |
| c) |
| Timeliness/effectiveness of contract problem resolution without extensive |
customer guidance.
E VG S M U
Contractor being evaluated______________________________________________ Client: _______________________________________________________________
2. SCHEDULE/TIMELINESS OF PERFORMANCE
| a) |
| Timeliness of submittals, reports, and other documents |
| E VG S M U N/A |
| b) |
| Compliance with work progress schedule |
| E VG S M U N/A |
| c) |
| Ability to complete work within contract time allowed |
| E VG S M U |
3. CUSTOMER SATISFACTION
| a) |
| To what extent were the end users satisfied with the project |
| E VG S M U |
| b) |
| Contractor was reasonable and cooperative in dealing with your staff |
Including the ability to successfully resolve disagreements/disputes
E VG S M U
| c) |
| To what extent was the contractor cooperative, businesslike, and concerned |
With the interests of the customer
E VG S M U
| d) |
| Responsiveness to customer’s requirements and concerns |
| E VG S M U |
| e) |
| Overall customer satisfaction |
| E VG S M U |
4. MANAGEMENT/PERSONNEL/LABOR
| a) |
| Effectiveness of on-site management, including management of suppliers, |
subcontractors and labor force
E VG S M U N/A
| b) |
| Ability to hire and retain a qualified workforce to this effort |
| E VG S M U N/A |
| c) |
| Knowledge/expertise demonstrated by contractor personnel |
| E VG S M U |
| d) |
| Effectiveness of overall management |
| E VG S M U |
5. COST/FINANCIAL MANAGEMENT
| a) |
| Ability to meet terms and conditions within the contractually agreed price |
| E VG S M U |
| b) |
| Has there been any indication that the contractor has had any financial problems? (if Yes, explain below) |
| Yes No |
6. SAFETY
| a) |
| To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan and respond to safety issues |
| E VG S M U |
7. GENERAL
| a) |
| Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM, or Contracting Officer in a timely manner regarding urgent contractual issues) |
| E VG S M U N/A |
| b) |
| Compliance with contractual terms/clauses |
| E VG S M U |
| c) | |
| Would you hire or work with this firm again? (If No, explain below) | |
| Yes | No |
| d) |
| Was this contract partially or completely terminated for default or convenience or are there any pending terminations (if Yes, explain below) |
Yes No
| e) |
| In summary, provide an overall rating for this contractor |
| E VG S M U |
REMARKS:
Email this questionnaire to: michael.carico@usda.gov Michael Carico, USDA Forest Service, no later than September 11, 2020.
File details come from the government source that posted it. Updated .