ATTH 15 Survey Attachment.docx

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HUD Nationwide Construction Inspection Services
Solicitation number
SOLICITATION-86614121R00001
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Attachment __

PAST PERFORMANCE INFORMATION (relevant services performed in the 5 years prior to submission of proposal)

PRIME CONTRACTOR OR PARTNER/SUBCONTRACTOR NAME_____________________________

CLIENT NAME *
POINT OF CONTACT NAME, ADDRESS, TELEPHONE
TYPE OF SERVICES PROVIDED
CONTRACT NUMBER, VALUE OF CONTRACT AND DATE SERVICES PROVIDED
MAGNITUDE
PRINCIPAL PARTNERS/KEY PERSONNEL

PPIRS

On File

HUD Office of Public and Indian Housing
John Doe, PIH Office of Technical Assistance, 1234 7th St, Washington, DC 78945 202-555-1234
Technical Assistance to public housing agencies
C-DEN-12345 $1,000,000

1/07 - 1/09

John Smith, Project Manager; Jane Doe, TA Specialist; John Smith Jr, Accounting Specialist

* If performance was as a subcontractor, this will be the name of the prime contractor.

Attachment __ - Past Performance Survey

PAST PERFORMANCE SURVEY

SOLICITATION NUMBER:

This past performance survey is to be completed on the designated contractor or key personnel as designated below:

PAST PERFORMANCE PROJECT IDENTIFICATON (To be filled out by the Offeror):

CONTRACTOR OR KEY PERSONNEL NAME:
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CONTRACT or ORDER NUMBER:
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PROJECT TITLE:
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TOTAL PERIOD OF PERFORMANCE, INCLUDING OPTIONS
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PAST PERFORMANCE REFERENCE INFORMATION (To be filled out by the Reference):

NAME:
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TITLE:
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AGENCY or CUSTOMER:
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PHONE:
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E-MAIL
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The Department of Housing and Urban Development (HUD) is procuring the services described in the box below. You have been selected by the contractor or key personnel identified above to provide past performance information to HUD to be used in evaluating the offeror’s proposal for this acquisition. Thank you for your input.

Summarize the services acquired here.
If this past performance survey is related to key personnel, please summarize the level of interface you had with the designated key personnel throughout the life of the project you oversaw.

For each of the Five (5) criteria listed below, the rater must choose One (1) Adjectival Rating by checking the box, as applicable. At a minimum, for any rating that is checked Exceptional, Very Good, Marginal or Unsatisfactory, please submit additional comments to substantiate the rating. If Cost Control is N/A, Please explain why.

1. QUALITY OF SERVICE

RATING
Adjectival Rating
Definition

Exceptional Performance meets contractual requirements and exceeds many to the Government’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor/Key Personnel were highly effective

Very Good Performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor/Key Personnel were effective

Satisfactory Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the Contractor/Key Personnel appear or were satisfactory

Marginal Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the Contractor/Key Personnel has not yet identified corrective actions.

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the Contractor’s/Key Personnel’s corrective actions appear or were ineffective.

ADDITIONAL COMMENTS:

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2. SCHEDULE

RATING
Adjectival Rating
Definition

Performance meets contractual requirements and exceeds many to the Government’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor/Key Personnel were highly effective

Performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor/Key Personnel were effective

Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the Contractor/Key Personnel appear or were satisfactory

Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the Contractor/Key Personnel has not yet identified corrective actions.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the Contractor’s/Key Personnel’s corrective actions appear or were ineffective.

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3. COST CONTROL

RATING
Adjectival Rating
Definition

Performance meets contractual requirements and exceeds many to the Government’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor/Key Personnel were highly effective

Performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor/Key Personnel were effective

Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the Contractor/Key Personnel appear or were satisfactory

Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the Contractor/Key Personnel has not yet identified corrective actions.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the Contractor’s/Key Personnel’s corrective actions appear or were ineffective.

Not Applicable

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4. BUSINESS RELATIONS

RATING
Adjectival Rating
Definition

Performance meets contractual requirements and exceeds many to the Government’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor/Key Personnel were highly effective

Performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor/Key Personnel were effective

Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the Contractor/Key Personnel appear or were satisfactory

Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the Contractor/Key Personnel has not yet identified corrective actions.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the Contractor’s/Key Personnel’s corrective actions appear or were ineffective.

Click here to enter text.

5. MANAGEMENT OF KEY PERSONNEL

RATING
Adjectival Rating
Definition

Performance meets contractual requirements and exceeds many to the Government’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the Contractor/Key Personnel were highly effective

Performance meets contractual requirements and exceeds some to the Government’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the Contractor/Key Personnel were effective

Performance meets contractual requirements. The element being assessed contains some minor problems for which corrective actions taken by the Contractor/Key Personnel appear or were satisfactory

Performance does not meet some contractual requirements. The element being assessed reflects a serious problem for which the Contractor/Key Personnel has not yet identified corrective actions.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the Contractor’s/Key Personnel’s corrective actions appear or were ineffective.

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