Past Performance Questionnaire_construction_template fillable.pdf

PDF 224 KB Posted Nov 23, 2010

Attached to: Single Award, Term, Indefinate Delivery, Indefinate Quanity (IDIQ) Multi trade, Small Construction Projects, for The General Services Administration, Public Building Service, Region 1, Boston Service Center
Solicitation number: GS-01P-11-BZD-0005
Issued by: General Services Administration Public Buildings Service

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Fillable PDF version of Vendor Past Performance Questionnaire

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Unit Price Agreement.xlsx	XLSX spreadsheet	Nov 23, 2010

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Revised: 09/27/2010

Construction

Vendor Past Performance Evaluation

Past Performance Questionnaire_construction_template Revised: 09/27/2010

2. CONTRACT NO. 3. CONTRACT TYPE

4. ORDER NO. 5. SOLICITATION NO.

7. CONTRACTING OFFICER

8. COTR/COR

9. ALTERNATE COTR/COR

10. CONTRACT VALU E (current plus any unexercised options)

11. CONTRACT AWARD DATE

12. CONTRACT EXPIRATION DATE

1b. ADD'L OR ALTERNATE CONTRACTOR NAME

1c. DUNS/DUNS Plus 4

1d. NAICS

21. DESCRIPTION OF REQUIREMENTS

22. RATINGS –Summarize contractor performance and check the box corresponding to the performance rating for each category. See Attachment A for rating descriptions.

(a) QUALITY OF PRODUCT OR SERVICE

CONSTRUCTION CONTRACTOR PERFORMANCE EVALUATION

1a. CONTRACTOR NAME AND ADDRESS (Identify Division)

6. CONTRACTING OFFICE NAME AND ADDRESS

13. EVALUATION PERIOD

(including any option periods)

FROM:

TO:

14. BASIC CONTRACT DOLLAR 15. TOTAL DOLLAR VALUE OF MODIFICATION 16. LIQUID DAMAGES ASSESSED 17. NETAMOUNT PAID CONTRACTOR

VALUE

18. ORIGINAL COMPLETION DATE 19. FINAL COMPLETION DATE 20. WORK ACCEPTANCE DATE

COMMENTS

(a1) Quality of Workmanship 0 (a2) Adequacy of the CQC Plan 0 (a3) Implementation of the CQC Plan 0

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(a4) Quality of QC Documentation 0 (a5) Storage of Materials 0 (a6) Adequacy of Materials 0

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(a7) Adequacy of Submittals 0 (a8) Adequacy of QC Testing 0 (a9) Adequacy of As-Builts 0

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(d) EFFECTIVENESS OF MANAGEMENT/BUSINESS RELATIONS

(al 0) Use of Specified Materials 0 (all) Identification/Correction of 0 Deficient Work

1 1

2 2

3 3

4 4

5 5

(b) 0 COMMENTS

COST CONTROL 1

COMMENTS

(cl) Adequacy of Initial Progress 0 (c2) Adherence to Approved Schedule 0 (c3) Resolution of Delays 0 Schedule

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(c4) Submission of Required 0 (c5) Completion of Punch List Items 0 (c6) Submission of Updated and Revised Progress Schedules

Documentation

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(c7) Warranty Response 0

COMMENTS

(d1) Cooperation and Responsiveness 0 (d2) Management of 0 (d3) Coordination and Control of

Resources/Personnel Subcontractors

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(d4) Adequacy of Site Clean-up 0 (d5) Effectiveness of Job-Site 0 (d6) Compliance with Laws and 0 Regulations Regulations

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

25a. Vendor Manager/Principal Investigator COMMENTS

25b. Vendor Key Person COMMENTS

25c. Additional Vendor Key Person COMMENTS

(e) COMPLIANCE WITH LABOR STANDARDS

(f) COMPLIANCE WITH SAFETY STANDARDS

YES

(G) Professional Conduct 0 (0) Review/Resolution of Subcontractor’s Issues

0 (d9) Change Order Activity by 0 Contractor

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(d 1 0) Adequacy of Work Force 0 (d1 1) O&M Manuals/Instructions 0 (d1 2) Spare Parts Delivery 0

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

COMMENTS

(e1) Correction of Noted Deficiencies 0 (e2) Payrolls Properly Completed and 0 (e3) Compliance with Labor Laws and Regulation with Specific Attention to the

Davis-Bacon Act and EEO

Submitted

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

COMMENTS

(f1) Adequacy of Safety Plans 0 (f2) Implementation of Safety Plans 0 (f3) Correction of Noted Deficiencies 0

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

(g) 0 COMMENTS

OVERALL RATING 1

23. TOTAL

24. SUBCONTRACT INFORMATION

24a. Are subcontracts COMMENTS involved with this contract?

25. VENDOR PERSONNEL

26a. Did the vendor make a good faith effort to comply with its subcontracting plan consistent with the goals and objectives, reporting and other aspects of the plan?

YES

26b. Did the vendor meet the goals and objectives for small business participation for bundled contracts?

YES

28a. Is the vendor committed to customer satisfaction?

YES

28b. Would you recommend using this vendor again? YES

YES

26. SMALL BUSINESS SUBCONTRACTING PLAN

COMMENTS

27. SMALL DISADVANTAGED BUSINESS (SDB) GOALS

27a. Did the vendor make a good faith effort to comply with its subcontracting plan consistent with the goals and objectives, for SDB participation, monetary targets for SDB participation and required notifications?

COMMENTS

28. CUSTOMER SATISFACTION

COMMENTS

29. SUPPLEMENTAL QUESTIONS

29a. QUESTIONS COMMENTS

30. EVALUATOR

30a. AGENCY/ORGANIZATION 30b. EVALUATOR (Name and Title)

30c. PHONE 30d. FAX NO.

30e. SIGNATURE OF EVALUAT OR 30f. EVALUATION TYPE 30g. EVALUATION DATE

Revised: 09/28/2010

Guidelines for Standard 6-Point and Construction Evaluation Types

RATING GUIDELINES PAGE 1 OF 2

6-Point Rating Scale

Quality of Product or Service

0 Unsatisfactory

Non-conformances are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards containing similar requirements.

1 Poor

Overall compliance requires significant Agency resources to ensure achievement of contract requirements.

2 Fair

Overall compliance requires minor Agency resources to ensure achievement of contract requirements.

3 Good

There are no, or very minimal, quality problems, and the Contractor has met contract requirements.

4 Excellent

There are no quality issues, and the Contractor has substantially exceeded the contract performance requirements without commensurate additional costs to the Government.

5 Outstanding

The Contractor has demonstrated an outstanding performance level that justifies adding a point to the scor e. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as “Excellent”.

Cost Control

0 Unsatisfactory

Ability to manage cost issues is jeopardizing perform ance of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, this level of ability to manage cost issues constitutes a significant impediment in consideration for future awards.

1 Poor

Ability to manage cost issues requires significant Agency resources to ensure achievement of contract requirements.

2 Fair

Ability to manage cost issues requires minor Agency resources to ensure achievement of contract requirements.

3 Good

There are no, or very minimal, cost management issues, and the Contractor has met contract requirements.

4 Excellent

There are no cost management issues, and the Contractor has exceeded the contract requirements, achieving cost savings to the government.

5 Outstanding

The Contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where the Contractor achieved cost savings and performanc e clearly exceeds the performance levels described as “Excellent”.

Timeliness of Performance

0 Unsatisfactory

Delays are jeopardizing the achievement of contract requirements, despite use of Agency resources. Recovery is not likely. If performance cannot be substantially corrected, it constitutes a significant impediment in consideration for future awards.

1 Poor

Delays require significant Agency resources to ensure achievement of contract requirements.

2 Fair

Delays require minor Agency resources to ensure achievement of contract requirements.

3 Good

There are no, or minimal, delays that impact achievement of contract requirements.

4 Excellent

There are no delays and the Contractor has exceeded the agreed upon time schedule.

5 Outstanding

The Contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected t hat this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as “Excellent”.

RATING GUIDELINES PAGE 2 OF 2

Business Relations

0 Unsatisfactory

Response to inquiries and/or technical, service, administrative issues is not effective. If not substantially mitigated or co rrected it should constitute a significant impediment in considerations for future awards.

1 Poor

Response to inquiries and/or technical, service, administrative issues is marginally effective.

2 Fair

Response to inquiries and/or technical, service, administrative issues is somewhat effective.

3 Good

Response to inquiries and/or technical, service, administrative issues is consistently effective.

4 Excellent

Response to inquiries and/or technical, service, administrative issues exceeds Government expectation.

5 Outstanding

The Contractor has demonstrated an outstanding performance level that justifies adding a point to the score. It is expected that this rating will be used in those rare circumstances where contractor performance clearly exceeds the performance levels described as “Excellent”.

6_CONTRACTING_OFFICE_NAME_AND_ADDRESS:

13_EVALUATION_PERIOD_TO_including_any_option_perio:

15_TOTAL_DOLLAR_VALUE_OF_MODIFICATION:

16_LIQUID_DAMAGES_ASSESSED:

17_NETAMOUNT_PAID_CONTRACTOR:

18_ORIGINAL_COMPLETION_DATE:

19_FINAL_COMPLETION_DATE:

20_WORK_ACCEPTANCE_DATE:

22_RATINGS_Summarize_contractor_performance_and_ch:

a_QUALITY_OF_PRODUCT_OR_SERVICE:

COMMENTS:

a1_Quality_of_Workmanship:

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a2_Adequacy_of_the_CQC_Plan:

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a3_Implementation_of_the_CQC_Plan:

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a4_Quality_of_QC_Documentation:

a5_Storage_of_Materials:

a6_Adequacy_of_Materials:

a7_Adequacy_of_Submittals:

a8_Adequacy_of_QC_Testing:

a9_Adequacy_of_AsBuilts:

2_CONTRACT_NO:

3_CONTRACT_TYPE:

4_ORDER_NO:

5_SOLICITATION_NO:

7_CONTRACTING_OFFICER:

8_COTRCOR:

9_ALTERNATE_COTRCOR:

10_CONTRACT_VALU_E_current_plus_any_unexercised_op:

11_CONTRACT_AWARD_DATE:

12_CONTRACT_EXPIRATION_DATE:

1b_ADDL_OR_ALTERNATE_CONTRACTOR_NAME:

1c_DUNSDUNS_Plus_4:

Id_NAICS:

21_DESCRIPTION_OF_REQUIREMENTS:

al_0_Use_of_Specified_Materials:

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all_IdentificationCorrection_of_Deficient_Work:

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COST_CONTROL_b:

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c_TIMELINESS_OF_PERFORMANCE:

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c2_Adherence_to_Approved_Schedule:

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c3_Resolution_of_Delays:

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c5_Completion_of_Punch_List_Items:

c4_Submission_of_Required_Documentation:

c7_Warranty_Response:

d_EFFECTIVENESS_OF_MANAGEMENTBUSINESS_RELATIONS:

d1_Cooperation_and_Responsiveness:

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d2_Management_of_ResourcesPersonnel:

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d4_Adequacy_of_Site_Cleanup:

d5_Effectiveness_of_JobSite_Regulations:

d6_Compliance_with_Laws_and_Regulations:

G_Professional_Conduct:

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d_1_0_Adequacy_of_Work_Force:

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d1_1_OM_ManualsInstructions:

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d1_2_Spare_Parts_Delivery:

e_COMPLIANCE_WITH_LABOR_STANDARDS:

e1_Correction_of_Noted_Deficiencies:

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f_COMPLIANCE_WITH_SAFETY_STANDARDS:

f1_Adequacy_of_Safety_Plans:

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f2_Implementation_of_Safety_Plans:

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f3_Correction_of_Noted_Deficiencies:

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OVERALL_RATING_g:

COMMENTS1:

24_SUBCONTRACT_INFORMATION:

24_SUBCONTRACT_INFORMATION0: Off

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COMMENTS2:

25_VENDOR_PERSONNEL:

25a_Vendor_ManagerPrincipal_Investigator:

COMMENTS3:

25b_Vendor_Key_Person:

COMMENTS4:

25c_Additional_Vendor_Key_Person:

COMMENTS5:

26_SMALL_BUSINESS_SUBCONTRACTING_PLAN:

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COMMENTS6:

27a_Did_the_vendor_make_a_good_faith_effort_tocomp: Off

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COMMENTS8:

29a_QUESTIONS:

COMMENTS9:

30a_AGENCYORGANIZATION:

30b_EVALUATOR_Name_and_Title:

30c_PHONE:

30d_FAX_NO:

30e_SIGNATURE_OF_EVALUATOR:

30f_EVALUATION_TYPE:

30g_EVALUATION_DATE:

28b_Would_you_recommend_using_this_vendor_again:

File details come from the government source that posted it. Updated Nov 14, 2017.