Attach_J-1 _Past_Performance_Questionnaire.doc

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Attachment J-1

PAST PERFORMANCE QUESTIONNAIRE

Geotechnical Consultant Services I. Past Performance Reference Company Name:

Company Address:

Name of Point of Contact:

POC Information:

Company Being Evaluated:

Name of the Project:

Dates the work was performed:

Contract Number:

Contract Type:

Dollar Value (Annual):

Description of Services Provided: _______________________________________ __________________________________________________________________ __________________________________________________________________

II. Evaluation

Please answer questions 1 through 11 using the following criteria. Circle only one response per question. For elements rated "unsatisfactory," please comment on the specific problem(s) or performance failure(s) that prompted this rating.

4 - Exceptional: Performance met and exceeded many of the contractual requirements to the organization's benefit. The contractual performance of the element being evaluated was accomplished with few minor problems for which corrective actions were highly effective.

3 - Very Good: Performance met and exceeded some of the contractual requirements to the organization's benefit. The contractual performance of the element being evaluated was accomplished with some minor problems for which corrective actions were effective.

2 - Satisfactory: Performance met contractual requirements. The contractual performance of the element being evaluated was accomplished with some minor problems for which corrective actions were satisfactory.

1 – Marginal: Performance barely met contractual requirements. The contractual performance of the element being evaluated reflects a serious problem for which corrective actions have not yet been identified, appear only marginally effective or were not fully implemented.

0 – Unsatisfactory: Performance did not meet some contractual requirement and recovery is not likely in a timely manner. The contractual performance of the element being evaluated reflects serious problems for which corrective actions were ineffective.

N/A: Not Applicable or not observed.

1. Evaluate the contractor's overall commitment to quality performance and customer satisfaction.

4 3 2 1 0 N/A

Comment: ______________________________________________________

2. Evaluate the contractor's overall technical competence.

4 3 2 1 0 N/A

Comment: ______________________________________________________

3. Evaluate the contractor's cooperation and willingness to work as a team (with your personnel, other contractors, etc.).

4 3 2 1 0 N/A

Comment: ______________________________________________________

4. Evaluate the contractor's compliance with contractual requirements.

4 3 2 1 0 N/A

Comment: ______________________________________________________

5. Evaluate the contractor's responsiveness to contract, program and/or schedule changes.

4 3 2 1 0 N/A

Comment: ______________________________________________________

6. Evaluate the effectiveness of the contractor's overall quality control procedures.

4 3 2 1 0 N/A

Comment: ______________________________________________________

7. Evaluate the contractor's ability to overcome technical problems, labor issues, and/or other performance difficulties.

4 3 2 1 0 N/A

Comment: ______________________________________________________

8. Evaluate the contractor's ability to plan and conduct operations in the most cost effective manner.

4 3 2 1 0 N/A

Comment: ______________________________________________________

9. Evaluate the contractor's ability to adhere to schedules and complete work on time.

4 3 2 1 0 N/A

Comment: ______________________________________________________

10. Evaluate the quality and stability of the contractor's workforce.

4 3 2 1 0 N/A

Comment: ______________________________________________________

11. Evaluate the availability, adequacy and suitability of the contractor's staffing for the work required.

4 3 2 1 0 N/A

Comment: ______________________________________________________