PAST PERFORMANCE QUESTIONNAIRE_Completed By Reference Provider.pdf

PAST PERFORMANCE QUESTIONNAIRE

FOR OWNER, CONTRACTING OFFICER (CO); OR

CONTRACTING OFFICER’S REPRESENTATIVE (COR)

Instructions to reference providers for returning this questionnaire:

Upon completion of the questionnaire, the Owner or CO/COR shall ensure that each page of this questionnaire has been accurately and completely filled out.

Submissions by reference provider via email attachment: The Owner or CO/COR shall ensure that the last page of this questionnaire contains his/her electronically signature with an encryption stamp.

Emailed attachment may be sent directly to the Contract Specialist, Ms. Sonah Lee:

sonah.lee@gsa.gov.

Submissions by reference provider via postal mail: The Owner or CO/COR shall ensure that the last page of this questionnaire contains his/her original signature in black or blue ink. The survey shall be placed in an envelope that must be sealed. The Owner or CO/COR shall place his/her signature across the actual envelope seal and include the following statement: "Confidential – Information enclosed is for the sole use of the government." The sealed envelope shall then be returned to the offeror. The offeror will forward the sealed envelope containing the Owner’s evaluation or CO/COR’s evaluation with the rest of their proposal to GSA. For projects that are not 100% complete, responses should be provided as to offeror’s performance to date.

Reference providers may attach additional sheets as necessary to fully answer any of the below questions.

Name of offeror being evaluated:

Owner or CO/COR’s contact information (First and Last Name, Title, Company Name, Address, and Telephone Number).

Type of work the offeror actually performed for you.

Location of work the offeror actually performed for you.

Original Contract Amount:

Actual/Current Contract Amount:

mailto:sonah.lee@gsa.gov

Original Period of Performance (Start and Completion Date):

Actual Period of Performance (Start and Completion Date):

Project Completion Percentage:

Type and Extent of Subcontracting:

A. TIMELINESS OF PERFORMANCE AND DELIVERABLES

1. Did the offeror complete the required work and submitted deliverables on schedule?

2. How responsive was the offeror in addressing unforeseen/unanticipated conditions?

3. Did the offeror provide timely monthly progress reports?

_______YES ______ NO

4. Please rate the offeror's timeliness of performance. (Circle one)

Excellent Good Acceptable Unacceptable

B. COST CONTROL

5. Did the offeror submit reasonable price proposals when repairs exceeded the base services of the contract?

6. Please rate the offeror's cost control procedures and its application of those procedures. (Circle one)

C. QUALITY CONTROL

7. How well has the offeror complied with contract requirements?

8. Did the offeror have the ability to adapt to changing requirements while maintaining a desired level of quality?

9. Please rate the offeror’s quality control procedures and its application of those procedures. (Circle one)

D. BUSINESS RELATIONS

10. How well did the offeror work with the owner and the owner's technical advisors?

11. Was the offeror cooperative, businesslike, and concerned with the interests of projects related to third party entities (i.e. tenants)?

12. Please rate the offeror’s business relations. (Circle one)

Evaluated By:

Signature and Date:

Name and Title:

Organization: