B2.09.3_DRAFT-RFP_Sec_L-Attachment_C_Past_Performance_Questionnaire_Draft.docx
DOCX document 59 KB Posted
- Solicitation number
- SLAC_DRAFT_RFP_369005_CRMF_Cleanroom_Construction
- Issued by
-
Department of Energy Office of Science
About this file
This is a Past Performance Questionnaire template designed to evaluate contractor performance on completed or ongoing federal contracts, specifically for use in the source selection process for RFP No. 369005 related to CRMF Cleanroom and UPW Construction at SLAC National Accelerator Laboratory.
The questionnaire is organized into six sections requiring evaluators to document contract identification details (contractor name, CAGE code, contract number, type, competitiveness, period of performance, and cost information), customer/agency identification, evaluator credentials, and comprehensive performance ratings. The evaluation component uses a five-point scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, or Not Applicable) to assess contractor performance across five key categories: Quality of Product or Service (eight sub-factors including workmanship, quality, requirements understanding, QC plan implementation, and technical responsiveness); Project Management (ten sub-factors including cooperation, resource management, subcontractor control, schedule management, and compliance with terms); Timeliness of Performance (five sub-factors including schedule compliance and documentation submission); Cost Performance (five sub-factors including cost reporting accuracy, forecasted cost performance, and cost savings innovations); and Safety and Health (three sub-factors including safety record and OSHA compliance). The questionnaire additionally requires narrative responses regarding overall strengths and weaknesses, future solicitation reservations, OSHA recordable cases or DARTs, terminations for default or convenience, and general performance comments. Completed questionnaires are designated as source selection sensitive information per FAR 3.104 and must be returned to the SLAC Procurement Specialist.
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Text version
SECTION L - ATTACHMENT C
RFP No: 369005
PAST/PERFORMANCE QUESTIONNAIRE
WHEN FILLED IN, THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104
SECTION 1: CONTRACT IDENTIFICATION
A. Contractor: Click here to enter text.
B. Cage Code of contractor contract was awarded to: Click here to enter text.
C. Contract number: Click here to enter text.
D. Contract type: Click here to enter text.
E. Was this a competitive contract? Yes ☐ No☐
F. Period of performance: From Click here to enter a date. to Click here to enter a date.
| Original Schedule: From Click here to enter a date. to Click here to enter a date. |
| Reason for difference: Click here to enter text. |
G. Initial contract cost: $Click here to enter an amount.
Current/final contract cost: $ Click here to enter an amount.
Reasons for differences: Click here to enter text.
H. Description of service provided:
Click here to enter text.
SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION
A. Customer or agency: Click here to enter text.
B. Customer or agency description (if applicable): Click here to enter text.
C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:
Click here to enter text.
D. Contact information Phone/Email): Click here to enter text.
SECTION 3: EVALUATOR IDENTIFICATION
A. Evaluator's name: Click here to enter text.
B. Evaluator's title: Click here to enter text.
C. Evaluator's phone number: Click here to enter text.
D. Evaluator’s Email address: Click here to enter text.
Number of years evaluator worked on subject contract: Click here to enter text.
SECTION 4: EVALUATION
1. Please indicate your satisfaction with the contractor’s past performance or performance thus far, if still working on the project. Place an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:
CODE PERFORMANCE LEVEL
E EXCEPTIONAL - The contractor’s performance met contractual requirements and exceeded requirements (20% or more) to the Customer’s or Government’s benefit. The contractual performance was accomplished with a few minor problems for which corrective actions taken by the contractor were highly effective.
VG VERY GOOD- The contractor’s performance met contractual requirements and exceeded requirements (5% or more) to the Customer’s or Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
S SATISFACTORY – The contractor’s performance met contractual requirements. he contractual performance contained some minor problems for which corrective actions taken by the contractor were satisfactory.
M MARGINAL – Performance did not meet some contractual requirements. The contractual performance reflected a serious problem for which the contractor did not identify corrective actions, or the actions were only marginally effective.
U UNSATISFACTORY – Performance did not meet most contractual requirements and recovery was not accomplished in a timely manner. The contractual performance contained serious problem(s) for which the contractor’s corrective actions were ineffective.
NA NOT APPLICABLE - Unable to provide a score.
The questions shown below should be tailored to the Factors/Subfactors of the instant acquisition.
| Quality of Product or Service (Technical Performance) |
| E |
| VG |
| S |
| M |
| U |
| NA |
| Q1. Quality of Workmanship and Service |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| Q2. Quality of Product or Service |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| Q3. Understanding of Requirements |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| Q4. Adequacy and Implementation of QC Plan |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| Q5. Responsiveness to technical direction and/or challenges |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| Q6. Completeness of Submittal |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| Q7. Frequency of Resubmittal |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| Q8. Identification/Correction of Deficient Work |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
Additional Comments and examples on factors marked as E (Exceptional), M (Marginal) or U (Unsatisfactory)
| Project Management |
| E |
| VG |
| S |
| M |
| U |
| NA |
| P1. Management Cooperation and Responsiveness |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P2. Management of Resources/Personnel |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P3. Effectiveness of On-Site Management and Control of Subcontractors |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P4. Site Planning/Adequacy of Site Clean-Up |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P5. Effectiveness of Job-Site Regulations |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P6. Review/Resolution of Subcontractor’s Issues |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P7. Change Order Activity |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P8. Compliance with Contractual Terms and Conditions |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P9. Ability to hire/retain a qualified workforce |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| P10. Contractor ability to smoothly transition resources/personnel |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
Additional Comments and examples on factors marked as E (Exceptional), M (Marginal) or U (Unsatisfactory)
| Timeliness of Performance |
| E |
| VG |
| S |
| M |
| U |
| NA |
| T1. Compliance with Contract Delivery/Completion Schedules |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| T2. Resolution of Delays |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| T3. Submission of Required Documentation |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| T4. Completion of Punch List Items |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| T5. Submission of Updated Progress Schedule |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
Additional Comments and examples on factors marked as E (Exceptional), M (Marginal) or U (Unsatisfactory)
| Cost Performance |
| E |
| VS |
| S |
| M |
| U |
| NA |
| C1. Accuracy and Timeliness of Cost Reporting |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| C2. Ability to meet forecasted costs and perform within contract costs |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| C3. Fair and Reasonable Change Order Requests |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| C4. Innovations that resulted in Cost Savings |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| C5. Subcontract Cost Management |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
Additional Comments and examples on factors marked as E (Exceptional), M (Marginal) or U (Unsatisfactory)
| Safety and Health |
| E |
| VS |
| S |
| M |
| U |
| NA |
| S1. Contractor Safety Record |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| S2. Conformance with Contract Safety and Health Requirements |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| S3. Adequacy and Implementation of Safety Plan |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
| ☐ |
Additional Comments and examples on factors marked as E (Exceptional), M (Marginal) or U (Unsatisfactory)
3. Highlight overall work completed by subcontractor with strengths and weaknesses: Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs? Yes/No
Please explain your response:
Click here to enter text.
4. Did the General Contractor, or their subs, have any OSHA Recordable Cases, or DARTs? Yes/No
If so, please describe the nature of the injury, and whether the contractor’s response was appropriate/satisfactory.
Click here to enter text.
5. Provide any additional comments concerning this contractor’s performance, as desired.
Click here to enter text.
6. Government Contracts Only: Has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations?
| Yes☐ | Default ☐ | Convenience ☐ | Pending Terminations ☐ |
| No ☐ |
If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc).
Click here to enter text.
Please sign and date below. Thank you for your prompt response and assistance!
| Click here to enter a date. | ||
| Evaluator’s Signature | Date |
Please return this completed questionnaire via email to the SLAC Procurement Specialist (only):
Jennifer Jamison at jjamison@slac.stanford.edu
File details come from the government source that posted it. Updated .