Past_Performance_Questionnaire.doc

SUBMIT TO CLIENT REFERENCES FOR PAST PERFORMANCE

PAST PERFORMANCE QUESTIONNAIRE

TO BE COMPLETED BY CLIENT'S TECHNICAL MANAGER or BUSINESS MANAGER or AGENCY'S CONTRACTING OFFICER REPRESENTATIVE (COR) or CONTRACTING OFFICER (CO) Please forward completed Past Performance Questionnaire to Alfred Benton, Contracting Officer, at abenton@usgs.gov. Please ensure delivery no later than the proposal due date listed in the RFQ.

____ Fixed-Price

____ Cost-Reimbursement

____ Other (Please Specify) ____________________

5. Client / Agency Name:

Address:

6. Client / Agency Point of Contact:

Name:

Title:

Phone:

E-mail Address:

9. Title of Project:

10. Please describe the work that was accomplished focusing on the scope and complexity of the work. Explain how the scope of the work is similar to the USGS project.:

11. Please describe whether the work was defined by the owner via a specification, statement of work, statement of objectives, partial/complete design document.

12. Did the Contractor encounter any noteworthy problems performing work? ________ If so, Please explain:

NOTE: Please use adjectival ratings from attached sheet

a. Quality of Services Received

b. Personnel

c. Subcontractor Mgmt

d. Business Relations

e. Timeliness of Performance

f. Customer Satisfaction

g. Financial Controls

16. Would you select this firm in the future for the same or similar services? Please explain.

PAST PERFORMANCE RATING GUIDELINES

Summarize contractor performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Marginal, Satisfactory, Very Good, or Excellent. Use the following instructions as guidance in making these evaluations. Note: There is no corresponding guidance for “Customer Satisfaction”. Please use the comments area on the preceding form to justify the rating given “Customer Satisfaction.”

-Compliance w/contract requirements -Effectiveness of design

-Quality of construction -Accuracy of reports

-Appropriateness of personnel assignments -Technical excellence

Financial Controls

-Within budget

-Current, accurate, complete billings

-Relationship of negotiated prices to actual

-Efficiencies

-Change orders issued Timeliness of

Performance

-Met interim milestones

-Reliable

-Responsive to technical direction

-Completed on time Business Relations / Subcontractor Management -Effective on-site management and personnel

-Businesslike correspondence

-Responsive to contract requirements

-Prompt notification of problems

-Reasonable / cooperative

-Flexible

-Proactive

-Effective Small Business

Subcontracting Program

Very Good

Any nonconformance experienced did not impact achievement of contract requirements Financial issues did not impact achievement of contract requirements Delays did not impact achievement of contract requirements

Business relations and interaction were usually effective

Satisfactory

Nonconformance required moderate agency involvement to ensure achievement of contract requirements

Business relations and interaction were somewhat effective

Marginal

Nonconformance required major agency involvement to ensure achievement of contract requirements

Business relations and interaction were marginally effective

compromised the achievement of contract requirements Financial issues compromised performance

G14PS000

Attachment H Past Performance Questionnaire

Attachment B Past Performance Questionnaire