J.4 Past Performance Questionnaire.rtf

PAST PERFORMANCE QUESTIONNAIRE

For use by The Architect of the Capitol Solicitation # [XXXXXXX] [also insert name of project here]

The company/individual listed below is preparing an offer on the above project for an agency in the federal government - the Architect of the Capitol (AOC) in Washington, DC. Your name/firm has been selected as a previous user of the below listed company with information on its past performance under a contract awarded by you/your firm. Your comments are considered Source Selection Sensitive, therefore, please be advised that your response to this Past Performance Questionnaire will be safeguarded to the extent cited in the Federal Acquisition Regulation (FAR) 42.1503. The FAR prohibits in part the release of past performance evaluations to other than other Government personnel used to evaluate source selection sensitive information.

This past performance questionnaire is being submitted to you/your firm by the company listed below, however, you are requested complete it and return it directly to AOC as follows. Please provide your responses to the AOC Contracting Officer of record, [CO– insert your name here] and send your response to this questionnaire to [CO - insert your workstation fax # or your AOC email address] on or before the proposal submission due date of [CO– provide the due date here]. While all elements in this questionnaire may not apply, please complete as much as possible.

Company/Individual Requesting Past Performance Information:

Name:

Past Project Title on Which the Company/Individual Is Being Evaluated

Project Title:

Name/Firm information: Point of Contact (POC) - for verification purposes

Name: Date:

Name for Point of Contact (for verification purposes):

Phone No.: Fax No.

E-mail Address:

Address:

Position held or function in relation to project:

Ratings: Please evaluate the contractor’s performance using the following ratings:

“O” Outstanding The contractor’s performance clearly exceeded the contract requirements.

“S” Satisfactory The contractor’s performance met the contract requirements.

“M” Marginal The contractor’s performance met the minimum contract requirements but with difficulty.

“U” Unsatisfactory The contractor’s performance was poor and/or did not satisfy contract requirements.

Please rate and provide supporting information for the following. If the rating is Outstanding or Unsatisfactory, please provide specific contract/job performance areas which were exceeded or not performed in accordance with the contract’s minimum requirements. (Use additional sheets as needed)

Performance in meeting delivery/completion schedules:

Rating:

2. What did the contractor do to improve or resolve schedule problems, if experienced?

3. How was the contractor’s quality control?

4. The contractor’s performance in delivering quality work in accordance with the contract:

5. The contractor’s ability to provide the required work at a reasonable total price:

6. Did the contractor comply with labor standards, if applicable?

7. Did the contractor comply with safety standards?

8. Was the contractor issued any of the following: Cure notice, show cause, letters of reprimand, suspension of payments, termination? If yes, please explain.

9. Would you award another contract to this contractor? If not, please state reasons:

10. Was the customer satisfied with the end product?

11. How was the relationship between the contractor and owner’s contract team/Contracting Officer/COR/COTR?

12. How was the contractor’s on-site management and coordination of subcontractors?

13. How was the contractor’s overall corporate management, integrity, reasonableness and cooperative conduct?

14. Did the contractor file any modifications? ________ How many and to what extent?

15. Has the contractor been provided an opportunity to discuss any negative performance ratings? ________ If so, what were the results?

16. OVERALL RATING:

17. Please provide any additional comments: