Section E Attachment D Past Performance Questionnaire.docx

Administrative and Technical Support Services, GS-08P-11-JE-D-0006 Section E, Attachment D, Past Performance Questionnaire

Note: Completed questionnaires shall be considered confidential information and may not be seen or reviewed by the contractor/Offeror. Mail or email completed questionnaires directly to:

Attention: Amy Lineberry, Contracting Officer General Services Administration Denver Federal Center Bldg. 41, P.O. Box 25546 (8P2PQ) Denver, CO 80225-0548 amy.lineberry@gsa.gov Name:

Company:

Role/position:

Current Telephone No.:

(Use this cover sheet for each past performance questionnaire submitted)

USE THIS QUESTIONNAIRE FOR THE OFFERING COMPANY’S PAST PERFORMANCE

OFFERING COMPANY’S PERFORMANCE EVALUATION QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

U.S. GENERAL SERVICES ADMINISTRATION

PUBLIC BUILDINGS SERVICE

ROCKY MOUNTAIN REGION

OVERVIEW

The Offeror shown below is submitting qualifications for the Administrative and Technical Support Services for GSA, Region 8, and provided your name as a customer reference. Part of our evaluation process requires information on the Offeror’s past performance. Your participation is important to us and responses are required by Thursday, March 3, 2011 2:00 P.M. (Mountain Time) for inclusion in our evaluation. Your assistance is greatly appreciated.

SECTION 1: Contract Identification To be completed by the Offeror and provided to the customer referenced

Name of Offeror being evaluated:

Project Number/Title:

Project Location:

Project Description:

Project Award Amount: $

Project Final Dollar Amount: $

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 Offeror 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:

Score Performance Level

5 EXCELLENT - 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.

4 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.

3 ACCEPTABLE – 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.

2 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.

1 UNACCEPTABLE – 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

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

Strengths of performance:

Weaknesses of performance:

Additional Thoughts:

Would you hire this firm again?

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, or email directly to:

U.S. General Services Administration Public Buildings Services P.O. Box 25546

Respondent Signature: _________________________________________ Date:_______________

USE THIS QUESTIONNAIRE FOR THE PROGRAM MANAGER AND CONTRACT ADMINISTRATOR’S PAST PERFORMANCE

CONTRACTOR PERFORMANCE EVALUATION QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

U.S. GENERAL SERVICES ADMINISTRATION

The Offeror shown below is submitting qualifications for Construction Manager (as Agent) services on the U.S. Federal Courthouse project in Billings, Montana, and provided your name as a customer reference. Part of our evaluation process requires information on the Offeror’s past performance. Your participation is important to us and responses are required by Thursday March 3, 2011, 2:00 PM (Mountain Time) for inclusion in our evaluation. Your assistance is greatly appreciated.

Name of Offeror being evaluated:

Project Number/Title:

Project Location:

Project Description:

Project Award Amount: $

Year Completed: Project Manager/Engineer:

Relation to Contract/Project:

Company Name:

Phone Number (Commercial/DSN):

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:

Score Performance Level

5 EXCELLENT – 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.

4 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.

3 ACCEPTABLE – 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.

2 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.

1 UNACCEPTABLE – 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.

Performance

Closeout

Please indicate in writing any additional comments you have of the Offeror and suggestions you may have concerning the following categories:

Strengths of performance:

Weaknesses of performance:

Additional Thoughts:

Would you work with this individual again?

USE THIS QUESTIONNAIRE FOR THE PROGRAM MANAGER AND CONTRACT ADMINISTRATOR’S PAST PERFORMANCE

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, or email directly to:

U.S. General Services Administration Public Buildings Services P.O. Box 25546

Respondent Signature: _________________________________________ Date:

USE THIS QUESTIONNAIRE FOR THE HUMAN RESOURCE MANAGER’S PAST PERFORMANCE

CONTRACTOR PERFORMANCE EVALUATION QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 3.104

U.S. GENERAL SERVICES ADMINISTRATION

The Offeror shown below is submitting qualifications for Construction Manager (as Agent) services on the U.S. Federal Courthouse project in Billings, Montana, and provided your name as a customer reference. Part of our evaluation process requires information on the Offeror’s past performance. Your participation is important to us and responses are required by Thursday, March 3, 2011, 2:00 PM (Mountain Time) for inclusion in our evaluation. Your assistance is greatly appreciated.

Name of Offeror being evaluated:

Project Number/Title:

Project Location:

Project Description:

Project Award Amount: $

Year Completed: Project Manager/Engineer:

Relation to Contract/Project:

Company Name:

Phone Number (Commercial/DSN):

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:

Score Performance Level

5 EXCELLENT - 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.

4 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.

3 ACCEPTABLE – 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.

2 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.

1 UNACCEPTABLE – 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.

Performance

Please indicate in writing any additional comments you have of the Offeror and suggestions you may have concerning the following categories:

Strengths of performance:

Weaknesses of performance:

Additional Thoughts:

Would you work with this individual again?

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, or email directly to:

U.S. General Services Administration Public Buildings Services P.O. Box 25546

Respondent Signature: _________________________________________ Date: