Design-Build Past Performance Questionaire.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 National Institutes of Health.

2. Please complete the attached Past Performance Questionnaire and return to the National Institutes of Health (NIH), Office of Acquisitions, ORF (OA-ORF) at the email address or facsimile number below.

Email Address: valeria.thomas@nih.gov Facsimile: (301) 402-0331.

3. It is very important that you complete and return this Questionnaire at your very first opportunity and no later than August 5, 2008.

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 NIH 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. Please complete and return this form and send it via email to valeria.thomas@nih.gov or facsimile to (301) 402-0331.

Thank you, Contracting Officer

NIH, OFFICE OF ACQUISITION, ORF

Solicitation No.NIHOF2008056 Contracting Officer: Valeria Thomas

Telephone: (301) 435-4326 / Fax No.: (301) 402-0331

PAST PERFORMANCE QUESTIONNAIRE

I. CONTRACTOR IDENTIFICATION (who is the subject of this questionnaire?)

A. CONTRACTOR’S NAME ______________________________________

B. CONTRACT #/LOCATION ____________________________________

C. TYPE OF CONTRACT THEY PERFORMED FOR YOU_________________

(Fixed Price, Cost Plus, etc.)

D. PERIOD OF PERFORMANCE __________________________________

E. CONTRACT AMOUNT $______________

(Including all option periods and modifications)

F. OWNER IDENTIFICATION (if “owner” is Government entity enter information in item 1; if commercial entity enter information in item 2)

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

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

II. ASSESSMENT OF CONTRACTOR’S PERFORMANCE

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:_____________________________________

Please rate the contractor’s 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. Space is provided for a narrative explanation in support of each rating. If the space is insufficient, please continue on an attached sheet.

B. QUALITY OF PAST PERFORMANCE:_____ Please rate/explain the quality of the contractor’s performance, including fulfillment of contractual requirements, quality of design, commitment to Owner satisfaction, professionalism and dependability, and workmanship. Also rate the timeliness of the contractor’s performance. Was the project completed and if so, were the milestones/phases achieved in a timely manner. Did the contractor properly provide, maintain and update the schedule?

Explanation/Narrative:_____________________________________

C. DEMONSTRATED COMMITMENT OF TEAM MEMBERS AND KEY

PERSONNEL:_____ Please rate the contractors leadership/ management abilities relative to its use of subcontractors/ team members. Please explain the rating and discuss the extent of the contractor’s reliance upon team members/ subcontractors for performance and how did the team members/subcontractors function and cooperate during performance? Please rate and explaining the contractor’s personnel turnover, if any include 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:___________________________________

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 Individual Providing Reference / Date