Attachment B Past Performance Questionnaire.docx

ATTACHMENT B - PAST PERFORMANCE QUESTIONNAIRE:

Notice of Opportunity issued by the General Services Administration Energy Savings Performance Contract (ESPC) National Deep Energy Retrofit (NDER) Round 7 Program

ESCOs: Please complete Section 1, and request that your Project Reference complete Section 2 and submit the completed questionnaire directly to heidi.johnson@gsa.gov and sharon.conger@gsa.gov by 12 noon (EST), June 19, 2023.

SECTION 1: CONTRACT INFORMATION (Contractor to complete questions #1-4)

1. Contractor Information:

Firm Name:

Address:

Point of Contact:

Contact Phone Number:

Contact email Address:

2. Work Performed as:

___ Prime Contractor ___Subcontractor ___Joint Venture ___Other (Explain) Percent of project work performed internally (by ESCO):

If subcontractor, who was the prime? (Firm name/phone #):

3. Contract Information:

Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: ___ ESPC ___Other (If “Other”, please specify type of contract, including Fixed Price/Cost Reimbursement/Time & Materials/Other):

Contract Title:

Contract Location(s) (city and state):

Type of Buildings/Facilities (circle all that apply): offices, laboratory space, data centers, warehouses, prisons, courthouses, military bases

Award Date (mm/dd/yy):

Original Scheduled Contract Acceptance (construction accepted) Date (mm/dd/yy):

Actual Contract Acceptance (construction accepted) Date (mm/dd/yy):

Explain Differences:

Original (awarded) Implementation Price (excludes finance and service period costs):

Original (awarded) Contract Price (all costs including design/implementation, finance, and service period costs):

Final/Current Contract Total Price: (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work: ___High ___Med ___Routine What were the major energy or water conservation measures implemented in the contract? (e.g., lighting, controls)

SECTION 2: EVALUATOR INFORMATION (Client Evaluator to complete items #5-7 and Past Performance Questionnaire below)

5. Evaluator Information:

Name:

Title:

Phone Number:

Email:

6. Describe the Evaluator’s role in the project:__________________________

7. Evaluator’s Signature: ______________________________________ Date: ________________

INSTRUCTIONS TO EVALUATOR: Thank you for your assistance. Your participation is very important to our procurement. Please provide responses to the questions below (as applicable) by circling the appropriate adjectival ratings. Please also provide brief comments addressing specific strengths, weaknesses, or deficiencies which may assist our office in evaluating performance risk (please attach additional pages if necessary). The Government reserves the right to verify any and all information on this form.

The completed questionnaire must be submitted directly by the Evaluator to the General Services Administration.

PLEASE SEND BY E-MAIL DIRECTLY TO:

heidi.johnson@gsa.gov with a courtesy copy to sharon.conger@gsa.gov

ADJECTIVAL RATINGS AND DEFINITIONS

PAST PERFORMANCE QUESTIONNAIRE

Please circle (or highlight) the adjectival rating which best reflects your evaluation of the contractor’s performance and provide comments explaining your rating. If you need additional space, please attach additional pages.

1. QUALITY

Comments Regarding Quality:

2. SCHEDULE/ TIMELINESS OF PERFORMANCE

Comments Regarding Schedule/Timeliness:

3. COMMUNICATION

a) Effectiveness of the contractor’s communication strategy (e.g. did you know who to call, did they call you when needed, and were they responsive, etc.)?

O AA S M U NA

Comments Regarding Communications:

4. MANAGEMENT/ PERSONNEL/ LABOR

Comments Regarding Management:

5. COST/ FINANCIAL MANAGEMENT

Comments Regarding Cost/Financial Management:

6. SAFETY/ SECURITY

Comments Regarding Safety/Security:

7. PERFORMANCE SUMMARY

Summary Comments:

Thank you for completing this questionnaire. Your assistance is sincerely appreciated.