PAST_PERFORMANCE_QUESTIONNAIRE.pdf

PAST PERFORMANCE QUESTIONNAIRE

E-MAIL COMPLETED SURVEY FORM TO:

C. E. John Hoddinott 301 C Street, SW Office of Acquisitions Bureau of Engraving and Printing Washington, DC 20228

E-mail: charles.hoddinott@bep.gov

Please return completed questionnaires by 4:00PM EST on 4 August 2015.

A. GENERAL INFORMATION:

Contractor’s Name: _______________ Telephone Number:________________ Address: __________________________ Fax Number: _________________ Point of Contact: _________________________

Project Title and Brief Description of Work:

Contract Number Provided by Offeror: ___________________ Dollar Amount: __________*

Contract Period or Dates of Performance Provided by Offeror: ______________*

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

E G S M U N

Excepti onal

Good Satisfactory Marginal Unsatisf actory

Neutral

Perform ance meets contract ual require ments with many exceed ed to the Govern ment’s

Performance meets contractual requirements with some exceeded to the Government’ s benefit.

The contractual performance of the element or

Performance meets contractual requirements . The contractual performance of the element or sub-element contains some minor problems for which

Performa nce does not meet some contractu al requirem ents.

The contractu al performa nce of the

Performa nce does not meet most contractu al requirem ents and recovery is not likely in a timely manner.

The

Performa nce was not observed or not applicabl e to the current effort being reported against.

mailto:charles.hoddinott@bep.gov

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent: _____________________ Title:

Address: _____________________ Telephone Number: ___________________ __________ _____________________________ Email Address: _____________________

C. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR YOUR RATINGS.

CONTRACTOR’S NAME: _______________

CONTRACT NUMBER: _______________

benefit.

The contract ual perform ance of the element or sub-element being assesse d was accomp lished with no more than a few minor problem s for which correcti ve actions taken by the contract or were highly effectiv e.

sub-element being assessed was accomplishe d with no more than some minor problems for which corrective actions taken by the contractor were effective.

corrective actions taken by the contractor were satisfactory.

element or sub-element being assessed reflects a serious problem for which the contracto r has not yet identified corrective actions or the contracto r’s proposed actions appear only marginall y effective or were not fully implemen ted.

contractu al performa nce of the element or sub-element contains a serious problem(

s) for which the contracto r’s corrective actions appear or were ineffectiv e.

Place an “X” in the appropriate column using the definitions matrix above.

The contractor:

Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

Delegated authority to project managers and supervisors commensurate with contract requirements.

Home office participated in solving significant local problems.

Followed approved quality control plan.

Provided effective quality control and/or inspection procedures to meet contract requirements.

Corrected deficiencies in timely manner and pursuant to their quality control procedures.

Provided timely resolution of contract discrepancies.

Identified problems as they occurred.

Suggested alternative approaches to problems.

Displayed initiative to solve problems.

Developed realistic progress schedules.

Met established project schedules.

Provided timely resolution of warranty defects.

The contractor:

Was responsive to contract changes.

Provided adequate project supervision.

Obtained consent of surety for increases in bonding as work-in-progress increased.

Paid subcontractors/suppliers in a timely manner.

Provided accurate and complete line item cost proposals including all aspects of work required for each task.

Cooperated with Government personnel after award.

How would you rate the contractor's overall performance?

Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES/

NO

Would you award another contract to this contractor? If not, explain in “remarks.”

YES/

NO

CONTRACTOR’S NAME: ___________________

CONTRACT NUMBER: _______________

Remarks:_________________________________________________________