Past Perf Questionnaire.doc

PERFORMANCE EVALUATION CONTRACTOR PERFORMANCE QUESTIONNAIRE

When filled in this document is source selection sensitive information iaw FAR 3.104

OVERVIEW

The Offerer shown below is submitting a proposal on a Los Angeles AFB, CA construction/service project and provided your name as a customer reference. Part of our evaluation process requires information on the Offerer’s past performance. Your participation is important to us and responses are required by ______________ for inclusion in our evaluation. Your assistance is greatly appreciated.

SECTION 1: Contract Identification

To be completed by the Offerer and provided to the customer referenced Name of Offerer being evaluated: _______________________________________ Project Number/Title: _________________________________________________ Project Location:_____________________________________________________ Project Description: ___________________________________________________ Project Award Amount (K): _______ Project Final Dollar Amount (K):_______ Year Completed: _________ Project Manager: _________________________ SECTION 2: Respondent Identification

Name of Evaluator: ________________________________________________ Relation to Contract/Project: ___________________________________________

Company Name: ____________________________________________________

Phone Number (Commercial/DSN): ____________________________________

Email Address: ____________________________________________________

SECTION 3: Rating of Offerer To be completed by the customer:

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

Code Performance Level EXCEPTIONAL - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s or customer’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD- The contractor’s performance meets or exceeds contractual requirements to the Government’s or customer’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

SATISFACTORY – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appears, or were, satisfactory.

MARGINAL – Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N NOT APPLICABLE - Unable to provide a score.

Management Professional conduct

Cooperation/responsiveness –timely, solicits feedback, suggests alternatives

Offerer is easy to work with, friendly, courteous

Oversight of project management/superintendents

Quickly/professionally resolves issues/disputes

Review/resolution of subcontractors issues

Clear line of supervision on construction site, effective

Followed and maintained project budget

Implementation of Subcontracting Plan (applicable to large businesses)

Design

Design submittals provided on time/schedule

Adequacy of submittals - re-submittals not excessive, clear/concise data

Timeliness of response to design comments

Inclusion of proper, industry accepted, documents

Plans comply w/applicable codes and are properly designed/stamped/approved

Quickly identifies design issues for resolution

Competency of design staff

Construction Compliance with laws and regulations

Coordination\control of subcontractors – ensures adherence to work schedule

Resource Management – maintains good construction pace/work environment

Site Management (i.e. materials properly staged/stored, job site cleanliness)

Adequacy & adherence of initial progress schedule/submission of revisions

Resolution of Delays

Timely completion of punch-list items

Adequacy and implementation of Safety Plan

Use of specified/equal materials

Identification/correction of deficient work in a timely manner

Quality of workmanship

Adequacy of QC Testing – provides all tests as required

Closeout/Warranty Submission of required documentation

Timeliness of submissions

Adequacy of As-Builts - maintains accurate red line drawings on site per specs

Format of closeout documentation

Warranty response

Correction of noted deficiencies

SECTION 4: Narrative Summary Please indicate in writing any additional comments you have of the Offerer and suggestions you may have concerning the following categories:

Strengths of performance: ____________________________________________________________________ Weaknesses of performance: __________________________________________________________________ Additional Thoughts: ________________________________________________________________________ SECTION 5: Submission

Thank you for taking the time to fill out this questionnaire. As stated above, when filled in this document is source selection sensitive information IAW FAR 3.104. When completed please mail, hand-deliver, email or fax directly to:

61 CONS/LGCA

FAX: (310) 653-5376

ATTN:

INSERT CA name

EMAIL: INSERT CA name @losangeles.af.mil

483 North Aviation Blvd

DUTY PHONE: (310) 653-XXXX

El Segundo, CA 90245

Respondents Signature: _________________________________________ Date: ______________________