Attachment_3_Past_Perf_Form.doc
DOC document 79 KB Posted
- Attached to
- Flat Deck Barge Federal contract opportunity
- Solicitation number
- NNS16597828R
About this file
Attachment 3 Past Performance Form
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 31G00-G002_Rev__1.pdf | ||
| NNS16597828R_Amendment_003.pdf | ||
| NNS16597828R_Amendment_0002.pdf | ||
| NNS16597828_Amendment_0001.pdf | ||
| Attachment_1_Specification__31G00-G002.pdf | ||
| Solicitation_NNS16597828R.pdf | ||
| Attachment_2_Solicitation_Provisions.pdf |
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Text version
PAST PERFORMANCE FORM
This form contains Source Selection Information when completed (See FAR 2.101 and 3.104) Return completed attachment to Ms. Leanne Olson at Leanne.Olson@nasa.gov or contact by phone at 228-688-1671.
NAME OF CONTRACTOR: ____________________________________________________________
[ ] Prime [ ] Team Member [ ] Other (Describe)
1. CUSTOMER/AGENCY NAME: ___________________________________________________
ADDRESS:_________________________________________________
TELEPHONE:_______________________________________________
2. CONTRACT NUMBER:_____________________________________
3. CONTRACT TYPE:________________________________________
4. CONTRACT AWARD AMOUNT: $_________________________________
5. FINAL PRICE OF CONTRACT: $________________________________________
6. VARIANCES: Explain variances from original contract value for the contract(s)
7. ORIGINAL AND MODIFIED PERIOD OF PERFORMANCE:
From: __________________________________ To: ____________________________________
8. COGNIZANT CONTRACTING OFFICER: (If commercial, customer’s business manager):
NAME: _________________________________ EMAIL: __________________________________
ADDRESS: ________________________________________________________
TELEPHONE: ______________________________ FAX: ____________________________________
9. CONTRACTING OFFICER’S TECHNICAL REPRESENTATIVE (If commercial, customer’s technical manager):
NAME: _________________________________ EMAIL: __________________________________
ADDRESS: _________________________________________________________
TELEPHONE: _____________________________ FAX: ____________________________________
10. CONTRACT STATUS (if current, show percent complete; if terminated, explain why; if complete, so state)
11. DESCRIPTION OF THE WORK PERFORMED (use additional page as necessary):
Past Performance Evaluation Form
(NAME OF CONTRACTOR:
CONTRACT#:
Please rate the Contractor in the applicable areas according to the applicable performance criteria.
A rating of "6" is best unless otherwise noted.
| NO |
| PERFORMANCE CRITERIA |
| MANAGEMENT |
| RATING |
| UNIT |
| 1 |
| Contractor's management abilities |
(1-6)
| 2 |
| Professionalism of Contractor |
(1-6)
| 3 |
| Subcontract Management |
(1-6)
| 4 |
| Contractor's flexibility in handling unforeseen events |
(1-6)
| 5 |
| Ability to communicate effectively |
(1-6)
| 6 |
| Ability to coordinate the effort of its subcontractors |
(1-6)
| 7 |
| Ability to adjust to schedule changes and outages |
(1-6)
| 8 |
| Ability to produce required permits/documentation |
(1-6)
| 9 |
| Response time to routine changes |
(1-6)
| 10 |
| Overall performance of Contractor |
(1-6)
| 11 |
| Your overall customer satisfaction |
(1-6)
| 12 |
| Your comfort level in hiring the Contractor again based solely on performance |
(1-6)
| 13 |
| Maintaining qualified key personal as described in offer |
(1-6)
TECHNICAL
| 14 |
| Overall quality and workmanship |
(1-6)
| 15 |
| Quality of Submittals (test results) |
(1-6)
| 16 |
| Ability to follow facility rules |
(1-6)
| 17 |
| Ability to minimize change orders/claims/requests for equitable adjustment |
(1-6)
| 18 |
| Ability to minimize lost production time |
(1-6)
| 19 |
| Ability to minimize defects |
(1-6)
| 20 |
| Contractor's housekeeping practices |
(1-6)
QUALITY CONTROL
(1-6)
| 21 |
| Contractor's knowledge of codes and regulations |
(1-6)
| 22 |
| Compliance with Owner's safety programs |
(1-6)
| 23 |
| EPA/DOL knowledge & compliance. Any known violations? |
Y/ N
(1-6)
| 24 |
| Work place violence incidents? |
Y/ N
(1-6)
SAFETY PROGRAM
(1-6)
| 25 |
| OSHA Violations past three years |
Y/ N
(1-6)
| 26 |
| Evaluation of TRIR Rates |
(2, 3, or 5)
| 27 |
| Evaluation of EMR Rates |
(2, 3, or 5)
(1-6)
| 28 |
| Evaluation of DART Rates |
(2, 3, or 5)
OTHER
| 29 |
| Response time to emergencies and changes |
Days
| 30 |
| Response time to warranty work requests |
Days
| 31 |
| Job completed on time (explain if No) |
Y/N
| 32 |
| Job completed ahead of schedule |
Y/N
| 33 |
| Any known lost time caused by onsite accidents (explain if Y) |
Y/ N
Y/N
| 34 |
| Any known transition impacts or negative impact on organization |
Y/ N
(1-6)
OVERALL RATING: [ ] Outstanding (6) [ ] Above Average (5) [ ] Neutral (4) [ ] Satisfactory (3) [ ] Marginal (2) [ ] Unsatisfactory (1)
Attachment 3
Attachment 3
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