Attachment_4_Individual_Past_Performance_Questionnaire.docx

ATTACHMENT 4: INDIVIDUAL PAST PERFORMANCE QUESTIONNAIRE

Your assistance is requested in support of a source selection.

Please complete this Questionnaire and send by electronic mail [annabelle.contee@gsa.gov] to:

Annabelle Contee, Procurement Analyst, GSA, NCR 301 7th Streets, SW; Room 2002 Washington, DC 20407

Annabelle Contee, Procurement Analyst, GSA, NCR 301 7th Streets, SW; Room 2002 Washington, DC 20407

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

TO BE COMPLETED BY PROSPECTIVE DB CONTRACT OFFEROR for the Center Building, St Elizabeths West Campus, SE, Wash., DC

1. CONTRACTOR’S (KEY PERSONNELS) NAME & ADDRESS:

4. CONTRACT NO.:

5. CONTRACT INITIATION DATE:

6. COMPLETION DATE:

2. OWNER’S NAME AND ADDRESS

7. CONTRACT VALUE $

8. TYPE OF CONTRACT:

3. PROJECT NAME:

9. DESCRIPTION OF PROJECT’S KEY CHARACTERISTICS:

Please add a continuation page if additional space is necessary.

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE (REFERENCE)

10. EVALUATION: a. EVALUATOR'S NAME, POSITION DURING PROJECT EXECUTION ( Project Manager/ COR/ Other) AND ORGANIZATION:

b. EVALUATOR'S PHONE NUMBER: c. MONTHS PERFORMANCE MONITORED BY EVALUATOR:

Please circle the response code for each topic that best reflects your experience with this Contractor.

EX = Exceptional VG = Very Good

S = Satisfactory MG = Marginal

US = Unsatisfactory N/O = Not Observed

A. Quality of Products and Services - Assess the individual’s performance in assuring conformance to contract requirements.

EX VG S MG US N/O

B. Overall Performance – Assess the individual’s overall performance on the project.

EX VG S MG US N/O

C. Initiative – Assess the individuals use of initiative to avoid problems and to respond to problems.

EX VG S MG US N/O

D. Technical Requirements – Assess the individual’s knowledge and ability to fulfill the technical requirements of the contract.

EX VG S MG US N/O

E. Cost Control – Assess the individual’s ability and willingness to manage the contract budget and control costs.

EX VG S MG US N/O

F. Customer Satisfaction – Assess the individual’s responsiveness to customer concerns and “user friendliness” in ROUTINE matters.

EX VG S MG US N/O

G. Customer Satisfaction – Assess the individual’s responsiveness to customer concerns and “user friendliness” in UNEXPECTED DIFFICULTIES.

EX VG S MG US N/O

H. Repeat Business -- Assess the likelihood that you would be willing to have this individual work on another project for you in the near future.

EX VG S MG US N/O

I. List individual’s Weak Points:

J. List the individual’s Strong Points:

K. List any other projects this individual has completed for you:

1. How long was this individual involved with this project?

2. What were his/her duties on this project?

3. Describe how this person met the milestones and if they were proactive in the management of the project, their responsiveness.

4. Describe the technical knowledge of this person during performance of this contract.

5. Describe the person’s proficiency in business controls (contracting, operations, accounting, and quality).

6. Describe the degree of difficulty or complicated aspects of the project (i.e. secure working areas, publicity and media coverage, etc.) and the person’s performance with difficult and complicated aspects of the project.

7. Were there any notable problems with this person’s performance, such as construction related matters that they could not resolve, how did they do at problem solving etc?

8. Describe why you would or would not contract with this person again for the same services.