B08_Attachment_7_Past_Performance_Questionnaire.pdf

PDF 43 KB Posted

Attached to
CONSTRUCT STEEL STORAGE/WORKSHOP BUILDIN Federal contract opportunity
Solicitation number
140G0125Q0065
Issued by
Department of the Interior US Geological Survey Office of Acquisitions and Grants

About this file

The document is a Past Performance Questionnaire template designed for contractors to submit references and performance evaluations from previous commercial or government contracts. The form is specifically associated with Solicitation Number 140G0125Q0065 for a steel storage/workshop building construction project for the US Geological Survey (USGS) Conte Anadromous Fish Lab Facility in Turners Falls, MA.

The questionnaire provides a structured format for collecting detailed performance feedback across multiple evaluation factors, including quality of services, personnel, subcontractor management, business relations, timeliness of performance, customer satisfaction, and financial controls. It includes a comprehensive rating scale from Unsatisfactory to Excellent, with specific guidelines for assessing contractor performance in each category. The form is to be completed by the client's technical or business manager, or the agency's Contracting Officer Representative (COR), and is intended to help evaluate a contractor's past performance for future contract opportunities.

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Past Performance Questionnaire

OFFEROR: SUBMIT TO YOUR COMMERCIAL CLIENT OR GOVERNMENT AGENCY REFERENCES FOR PAST PERFORMANCE

PAST PERFORMANCE QUESTIONNAIRE

TO BE COMPLETED BY COMMERCIAL CLIENT'S TECHNICAL MANAGER or BUSINESS MANAGER or AGENCY'S CONTRACTING OFFICER REPRESENTATIVE (COR) or CONTRACTING OFFICER (CO)

Solicitation No.:

Please forward completed Past Performance Questionnaire to (Contracting Officer’s name and email):

Deliver no later than close of business on (enter date):

1. Contractor Name: 2. Contract Number:

3. Contractor Address: 4. Contract Type:

____ Fixed-Price

____ Cost-Reimbursement

____ Other (Please Specify) ____________________

5. Client / Agency Name:

Address:

6. Client / Agency Point of Contact:

Name:

Title:

Phone:

E-mail Address:

7. Period of Performance: 8. Total Contract Value: $

9. Title of Project:

10. Please describe the work that was accomplished focusing on the scope and complexity of the work.:

11. Please describe whether the work was defined by the owner via a specification, statement of work, statement of objectives, partial/complete design document.

12. Did the Contractor encounter any noteworthy problems performing work? ________ If so, Please explain:

NOTE: Please use adjectival ratings from attached sheet

13. Evaluation Factor 14. Comments (Attach additional sheets, if necessary.) 15. Rating

a. Quality of Services Received

b. Personnel

c. Subcontractor Mgmt

d. Business Relations

e. Timeliness of Performance

f. Customer Satisfaction

g. Financial Controls

h. Small Business Subcontractor Goals Attainment

If a subcontracting plan was required under the contract, to what extent did the offeror attain goals for small business participation?

16. Would you select this firm in the future for the same or similar services? Please explain.

17a. Name of Preparer: 17b. Signature:

17c. Title: 17d. Date:

PAST PERFORMANCE RATING GUIDELINES

Summarize contractor performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Marginal, Satisfactory, Very Good, or Excellent. Use the following instructions as guidance in making these evaluations. Note: There is no corresponding guidance for “Customer Satisfaction”. Please use the comments area on the preceding form to justify the rating given “Customer Satisfaction.”

Ratings Quality of Services Received / Personnel -Compliance w/contract requirements -Effectiveness of design -Quality of construction -Accuracy of reports -Appropriateness of personnel assignments -Technical excellence

Financial Controls

-Within budget -Current, accurate, complete billings -Relationship of negotiated prices to actual -Efficiencies -Change orders issued

Timeliness of Performance

-Met interim milestones -Reliable -Responsive to technical direction -Completed on time

Business Relations / Subcontractor Management -Effective on-site management and personnel -Businesslike correspondence -Responsive to contract requirements -Prompt notification of problems -Reasonable / cooperative -Flexible -Proactive -Effective Small Business Subcontracting Program

Excellent There were no quality problems

There were no Financial issues

There were no delays

Business relations and interaction were highly effective

Very Good

Any nonconformance experienced did not impact achievement of contract requirements

Financial issues did not impact achievement of contract requirements

Delays did not impact achievement of contract requirements

Business relations and interaction were usually effective

Satisfactory

Nonconformance required moderate agency involvement to ensure achievement of contract requirements

Financial issues required moderate agency involvement to ensure achievement of contract requirements

Delays required moderate agency involvement to ensure achievement of contract requirements were somewhat effective

Marginal

Nonconformance required major agency involvement to ensure achievement of

Financial issues required major agency involvement to ensure achievement of contract requirements

Delays required major agency involvement to ensure achievement of contract requirements were marginally effective

Unsatisfactory Nonconformance compromised the achievement of contract requirements

Financial issues compromised performance

Delays compromised achievement of contract requirements

Business relations and interaction were not effective and compromised achievement of

Please forward completed Past Performance Questionnaire to Contracting Officers name and email: Dayna Parkin, dparkin@usgs.gov
Deliver no later than close of business on enter date:
3 Contractor Address:
FixedPrice:
CostReimbursement:
Other Please Specify:
undefined:
5 Client Agency Name Address:
7 Period of Performance:
8 Total Contract Value:
9 Title of Project:
10 Please describe the work that was accomplished focusing on the scope and complexity of the work:
11 Please describe whether the work was defined by the owner via a specification statement of work statement of objectives partialcomplete design document:
12 Did the Contractor encounter any noteworthy problems performing work If so Please explain:
14 Comments Attach additional sheets if necessarya Quality of Services Received:
15 Ratinga Quality of Services Received:
14 Comments Attach additional sheets if necessaryb Personnel:
15 Ratingb Personnel:
14 Comments Attach additional sheets if necessaryc Subcontractor Mgmt:
15 Ratingc Subcontractor Mgmt:
14 Comments Attach additional sheets if necessaryd Business Relations:
15 Ratingd Business Relations:
14 Comments Attach additional sheets if necessarye Timeliness of Performance:
15 Ratinge Timeliness of Performance:
14 Comments Attach additional sheets if necessaryf Customer Satisfaction:
15 Ratingf Customer Satisfaction:
14 Comments Attach additional sheets if necessaryg Financial Controls:
15 Ratingg Financial Controls:
If a subcontracting plan was required under the contract to what extent did the offeror attain goals for small business participation:
16 Would you select this firm in the future for the same or similar services Please explain:
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If so Please explain:
Text9: 140G0125Q0065
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