Evaluation_Form-_Attachment_B.docx

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Attached to
Strategic Planning using Appreciative Inquiry Federal contract opportunity
Solicitation number
DTMA9117R00012
Issued by
Department of Transportation Maritime Administration

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Attachment B- Evaluation Form

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PAST PERFORMANCE EVALUATION FORM

(Check appropriate box)

Performance Elements
Excellent
Good
Acceptable
Poor
Unacceptable

Quality of Services/ Work

Timeliness of Performance

Cost Control

Business Relations

Customer Satisfaction

1. Name & Title of Evaluator:

2. Signature of Evaluator:

3. Name of Organization:

4. Telephone Number of Evaluator:_

5. State type of service received:

6. State Contract Number, Amount and period of Performance

7. Remarks on Excellent Performance: Provide data supporting this observation. Continue on separate sheet if needed)

8. Remarks on unacceptable performance: Provide data supporting this observation. (Continue on separate sheet if needed)

DTMA9117R00012

ATTACHMENT B

RATING GUIDELINES

Summarize Contractor performance in each of the rating areas. Assign each area a rating of 0 (Unacceptable), 1 (Poor), 2 (Acceptable), 3 (Good), 4(Excellent), or ++ (Plus). Use the following instructions a guidance in making these evaluations.

Quality

Timeless
Business
Product/Service
Cost Control
of Performance
Relations
-Compliance with contract requirements
-Within budget (over/ under target costs)
-Meet Interim milestones

-Reliable -Effective management -Businesslike correspondence

-Accuracy of reports -Appropriateness of

-Current, accurate, and complete billings
-Responsive to technical directions
-Responsive to contract requirements

personnel -Technical excellence -Relationship of negated costs to actual -Cost efficiencies -Completed on time, including wrap-up and -contract administration -Prompt notification of contract problems -Reasonable/cooperative

-Change order issue
-No liquidated damages assessed
-Flexible

-Pro-active -effective contractor recommended solutions -Effective snail/small disadvantaged business Subcontracting program

0. Zero
Nonconformances are comprises the achievement of contract requirements, despite use of
Cost issues are comprising performance of contract requirements.
Delays are comprising

the achievement of contract requirements, Despite use Response to inquiries, technical/ service/administrative issues is not effective and responsive.

Agency resources of Agency resources.

1, Unacceptable
Nonconformances require major
Cost issues require major
Delays require major
response to inquiries, technical/
Agency resources to ensure achievement of contract requirements.
Agency resources to ensure achievement of contract requirements.
Agency resources to ensure achievement of contract requirements.
service/administrative issues is marginally effective and responsive.
2. Poor
Nonconformances require minor Agency resources to ensure achievement of contract
Costs issues require minor Agency resources to ensure achievement of contract
Delays require minor Agency resources to ensure achievement of contract
Responses to inquiries, technical/ service/administrative issues is somewhat effective and
requirements.
requirements.
requirements.
responsive.
3. Acceptable
Nonconformances do not impact
Cost issues do not impact
Delays do not impact
Responses to inquires, technical/
achievement of contract requirements.
achievement of contract requirements.
achievement of contract requirements.
service/administrative issues is usually effective and responsive.
4. Good
There are no quality problems.
There are no cost issues.
There are not delays.
Responses to inquiries, technical/ service/administrative issues is effective and responsive,

5. Excellent The contractor has demonstrated an exceptional performance level in some or all of the above categories.

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