Phase I Past Perf.doc

INSTRUCTIONS FOR PAST PERFORMANCE QUESTIONNAIRE

Instructions for Past Performance Reference:

1.

You have been designated as the point of contact for information relative to the past performance history/experience of an offeror competing in a design build project for the U.S. Coast Guard.

2.

Please complete the attached Past Performance Questionnaire and return it to the USCG Contracting Officer at the facsimile number below.

3.

It is very important that you complete and return this Questionnaire at your very first opportunity and no later than 14 June 2010.

4.

The information you provide is necessary and is considered an important component of the evaluation process.

5.

The information contained herein shall be treated as source selection sensitive and will not be provided to the contractor(s).

6.

You may be contacted by the USCG during the course of the evaluation process for further information. If you are other than a Federal Agency and require consent from the contractor/offeror to release information, the contractor/offeror will provide you with that consent (if not provided concurrent with these Instructions and Questionnaire).

7.

In the event you are a Federal Agency and you have performance evaluation records generated under FAR 42.15, please forward those records to me concurrent with the return of the completed Questionnaire. Please complete and return this form and send it to me via facsimile at (206) 220-7390. If you have any additional questions, please call me at (206) 220-7426.

Thank you, Contracting Officer

USCG Facilities Design & Construction Pacific

RFP No. HSCG50-10-R-PFDCLH Contracting Officer: Anita Repanich

Telephone: (206) 220-7426/ Fax No.: (206) 220-7390

PAST PERFORMANCE QUESTIONNAIRE

I. CONTRACT IDENTIFICATION

A. CONTRACTOR’S NAME ______________________________________

B. CONTRACT NUMBER/LOCATION _______________________________

C. CONTRACT TYPE __________________________________________

(Fixed Price, Cost Plus, etc.)

D. PERIOD OF PERFORMANCE __________________________________

E. ACTUAL OR ESTIMATED MAXIMUM ____________________________

CONTRACT TOTAL ________________

(Including all option periods and modifications)

F. CLIENT IDENTIFICATION

1. NAME OF GOVERNMENT ACTIVITY: Include Point of Contact, Phone number, Fax number and Address.

2. NAME OF COMMERCIAL ACTIVITY: Include Point of Contact, Phone number, Fax number, and Address.

II. ASSESSMENT OF CONTRACTORS PERFORMANCE

Please rate the contractors performance in the following categories on a scale of 0 to 5 as follows: 0 = Unsatisfactory; 1 = Marginal; 2 = Satisfactory; 3 = Good; 4 = Very Good; and 5 = Excellent. Also, please provide a detailed explanation/narrative in support of each rating in the space provided. If the space is insufficient, please continue on an attached sheet.

A. RELEVANCE OF PAST PERFORMANCE: Please explain the type/scope/magnitude of construction and construction related services provided by the contractor or contractor’s team (i.e. Design-Build, Design Bid Build, etc)”: Attach 8½" x 11" sheet for additional information.

Explanation/narrative:_________________________________________

B. QUALITY OF PAST PERFORMANCE: Please rate and explain the quality of the contractor’s performance.

1. Did the contractor fulfill contractual requirements. __________________

2. Rate the quality of design. ______________________________________

3. Quality of how contractor effectively coordinated design and engineering professionals, trade subcontractors and construction personnel in an integrated team effort. _________________________________________

4. Quality of contractor’s ability to appropriately staff the project _________

5. Quality of management and ensuring quality in the design and construction process. __________________________________________

6. Rate the contractor’s understanding of the level of detail of drawings and specifications to document the design build process. _________________

7. Quality of contractor’s management of the project to ensure continuous quality control from inception (design) to completion (construction acceptance). _________________________________________________

8. Quality of contractor’s commitment to Owner satisfaction. ____________

9. Quality of contractor’s performance and workmanship. _______________

10. Rate the timeliness of the contractor’s performance. Was the project completed and if so, were the milestones/phases achieved in a timely manner. ____________________________________________________________

11. Did the contractor properly provide, maintain and update the schedule.

Explanation: ________________________________________________

C. DEMONSTRATED COMMITMENT OF TEAM MEMBERS AND KEY

PERSONNEL: Please rate the contractors leadership/ management abilities relative to its use of subcontractors/ team members.

1. Rate the contractor’s reliance upon team members/subcontractors for performance. ___________________________________________________

2. Rate how the team members/subcontractors functioned and cooperated during performance. ___________________________________________________

3. Rate and explaining the contractor’s personnel turnover, if any including turnover of key/critical personnel and turnover of members/ subcontractors.

Explanation /Narrative: ________________________________________

D. PERFORMANCE PROBLEMS: Did the contractor contribute to any performance problems on the projects? If yes, please identify the performance problems. Include Contractor’s ability to communicate with the Owners. Was the Owner apprised of performance, including realistic progress reports and realistic assessment of problems? Was the Contractor’s cost control capabilities accurately tracked in a timely manner and/or accurately projected cost relative to any changes?

Explanation/Narrative:_________________________________________

E. SMALL BUSINESS SUBCONTRACTING PAST PERFORMANCE

SUBCONTRACTING GOALS: If subcontracting opportunities were required, did the contractor meet or exceed the requirements (i.e. SF 294 and SF 295's).

Explanation/Narrative:_________________________________________

III. WOULD YOU USE THE CONTRACTOR AGAIN (including team members and subcontractors)? Please explain the basis for your conclusion?

Explanation/Narrative:_________________________________________

IV. OVERALL RATING AND ADDITIONAL COMMENTS

Please provide an overall rating of the Contractor and please provide any additional comments that you believe will be helpful relative to the Coast Guard evaluation of the contractor.

Printed Name of Individual Providing Reference

Signature of Authorized Representative / Reference Date Past Performance Questionnaire