15._Attachment_D-PAST_PERFORMANCE_QUESTIONNAIRE.docx

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Attached to
Microwave Tower Inspections Federal contract opportunity
Solicitation number
DE-SOL-0010067
Issued by
Department of Energy Western Area Power Administration

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ATTACHMENT D PAST PERFORMANCE QUESTIONNAIRE

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11g.__2016_WD05-2587_NE_and_WY.pdf PDF
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Text version

DEPARTMENT OF ENERGY/WESTERN AREA POWER ADMINISTRATION

DESERT SOUTHWEST REGION (DSW)

PAST PERFORMANCE QUESTIONNAIRE

Solicitation # DE-SOL-0010067

SECTION 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:

SECTION II. AGENCY (CUSTOMER) IDENTIFICATION

AGENCY (CUSTOMER) NAME:

POC NAME/TITLE/PHONE:

SECTION 3 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
e. Compliance with Davis-Bacon or other wage rate and labor usage requirements
E G S M U
f. Avoidance of accidents/safety violations
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

SECTION IV. COMMENTS FOR M = MARGINAL AND U = UNSATISFACTORY RATINGS

Item No.
Comment
PRINTED NAME: ______________________________
DATE:____________

SIGNATURE: __________________________________

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