pastperfattachment.doc

DTFH61-08-R-00023

Attachment No. 7

PAST PERFORMANCE QUESTIONNAIRE

Dear Evaluator, The company listed below plans on submitting a proposal to Federal Highway Administration (FHWA) in response to Request for Proposal Number DTFH61-08-R-00023, entitled, “Development and Deployment of Clarus-enabled services”. The organization listed below may be the prime offeror on the proposal or a proposed subcontractor.

Please complete the questionnaire below and provide any comments regarding the company’s performance on your project. Your input is greatly appreciated.

This information may be used by FHWA to assess the offeror’s past performance. The information provided will be deemed procurement sensitive, will remain proprietary and will not be released or disclosed outside the Government except as provided in FAR Subpart 24.2, Freedom of Information Act. The Government may discuss findings with the company surveyed.

Company Information:

Please list the name of the company being evaluated below.

Company Name: ______________________________________________________________________

Point of Contact: ______________________________________________________________________

Evaluator Information:

Name of Evaluator:

Evaluator’s Position Title:

Evaluator’s Organization/Office:

Questionnaire Completion Date:

Evaluator’s Contact Information:

Telephone:

Email:

Reference Project Information:

Provide the following information about the referenced project/contract.

Project/Contract Title:

Evaluator’s Period of Involvement:

Project/Contract Period of Performance:

Start:

Finish:

Contract Value:

Initial

Current

PAST PERFORMANCE QUESTIONAIRE

For the following questions, please circle/check the appropriate rating. Comment lines are provided for additional information if the #2 or #1 rating is given (however the comment lines may be used to provide any additional information deemed noteworthy).

High

Low

This area deals with compliance of contract requirements, to include appropriateness of personnel and technical excellence.

This area deals with the contractor’s ability to meet milestones and delivery schedules, to include responsiveness to technical direction, completion of efforts on time including wrap-up and contract administration.

This area deals with the contractor’s ability to control price/cost escalation during performance to include appropriate budgetary estimates, current/accurate/complete billings/invoices, relationship of negotiated costs to actual, claim submissions, cost efficiencies, and change order issues.

This area deals with the contractor’s commitment to satisfaction and cooperative/reasonable businesslike behavior with own staff and customers to include: effective management, responsiveness to contract requirements, operates with honesty and integrity, prompt notification of problems, flexible and proactive qualities, effective contractor-recommended solutions, and effective subcontracting and teaming arrangements.

Comments (attach additional pages as necessary):

GENERAL INFORMATION: Please provide answers to the following questions.

1. Has the contractor ever been given a cure notice, show cause notice, suspension of progress payments, or other letters directing the correction of a performance problem; or has this contract been partially or completely terminated, or is there any pending termination actions?

( ) No

( ) Yes

If yes:

( ) Default ( ) Convenience; and please explain:

2. Changes in contract dollar value throughout the life of the contract are/were attributable, for the most part, to:

( ) Government-issued change orders ( ) claims submitted by the contractor

( ) other Government actions ( ) other contractor actions (please explain below)

3. Based on this contractor’s overall performance, would you award this contractor another Government contract?

If no, please explain:

4. If any of the above responses are based on adverse past performance, have you discussed it with the contractor and has the contractor had an opportunity to comment?

( ) Not Applicable

If yes or no, please explain: