PAST PERFORMANCE QUESTIONNAIRE.pdf

PAST PERFORMANCE QUESTIONNAIRE

Complete Sections I and II and send to your list of references for past performance. Past Performance Questionnaires completed by your references MUST be received by the person indicated below NO

LATER THAN THE STATED CLOSING DATE OF THE RFQ.

All completed questionnaires shall be returned to:

Western Area Power Administration, Attn: Carol Hammans, A7100, PO Box 281213, Lakewood, CO 80228-8213, or Via email to hammans@wapa.gov or Via facsimile to (720) 962-7161

I. CONTRACT IDENTIFICATION

CONTRACTOR NAME: CONTRACT NO:

CONTRACTOR ADDRESS:

CONTRACT TYPE:

FIRM-FIXED-PRICE

COST REIMBURSEMENT

OTHER: (specify)

ACTIVE COMPLETED

ROUTINE COMPLEX

DATES OF PERFORMANCE:

AWARD AMOUNT: $

TOTAL WITH MODS $

PROJECT DESCRIPTION:

II. AGENCY (CUSTOMER) IDENTIFICATION

AGENCY (CUSTOMER) NAME:

POC NAME/TITLE/PHONE:

III. PAST PERFORMANCE RATING

Rating Scale: E = Excellent. Considerably surpassed requirements/expectations.

G = Good. Surpassed requirements/expectations.

S = Satisfactory. Met requirements/expectations M = Marginal. Met some requirements/expectations

U = Unsatisfactory. Did not meet requirements/expectations

1. QUALITY: (Circle applicable rating)

a. Conformance with contract requirements E G S M U

b. Quality of workmanship (including subcontractors) E G S M U

c. General oversight by project manager and superintendent E G S M U

d. Coordination with and control of subcontractors E G S M U

2. TIMELINESS:

a. Adherence to project delivery schedules E G S M U

b. Submission of change proposals E G S M U

c. Response to technical direction and change orders E G S M U

d. Response to correction of identified problems E G S M U

e. Submission of timely/accurate/complete billings E G S M U

f. Submission of materials/other submittals E G S M U

3. BUSINESS RELATIONS:

a. Flexibility and cooperativeness in resolving problems E G S M U

b. Tenacity and innovativeness in resolving problems E G S M U

c. Relationships with subcontractors, including prompt payment E G S M U

d. End user was satisfied with services performed

E G S M U

IV. COMMENTS

Required for ratings of C (Considerably Surpassed Requirements) or D (Did Not Meet Requirements)

Item No. Comment

Signature: Date: