AZ_-_MATOC_Past_Performance_Survey_Questionnaire.pdf

Past Performance Survey / Questionnaire P15PS00203 – AZ MATOC Contract Page 1 of 8

The Company who has provided you with this survey questionnaire is proposing on a contract for the

National Park Service. Past Performance is a very important evaluation factor for this acquisition, so input from previous customers of the offeror is very important. We would greatly appreciate you taking the time to complete this survey. The information is to be provided directly to the National Park

Service, Intermountain Region, Arizona Major Acquisition Buying Office (AZ MABO).

THE INFORMATION YOU PROVIDE WILL NOT BE DISCLOSED TO THE OFFEROR.

Please provide an honest assessment and immediately return to the e-mail or physical address provided below. If you have any questions, please contact Deborah Cimmer at 928.638.7434.

The NPS will use the information from this survey questionnaire to evaluate offerors competing for contract award. Please evaluate the contractor’s performance in each of the ratings areas described below. For each ratings area, please select the rating that most closely describes your evaluation of the contractor’s performance, by placing a check mark in the box next to or under it. Please provide written comments as needed to clarify / support each rating. If you wish, you may attach additional comments or information. Please complete and return this form as quickly as possible to the address provided below. Thank you in advance for your time, assistance and cooperation.

Please return this form to the following address, no later than the date requested by the offeror.

National Park Service, AZ MABO

Attn: Deborah J. Cimmer

1824 S. Thompson St., Suite 200

Flagstaff, AZ 86001

Or e-mail to deborah_cimmer@nps.gov

(928) 638-7434

Survey / Questionnaire Completed By:

Company / Agency / Organization

Name / Title of Reference

Telephone Number

E-mail Address

Signature mailto:deborah_cimmer@nps.gov

P15PS00203 – AZ MATOC Contract Page 2 of 8

Part 1

(To Be Completed by Company / Firm Requesting Reference)

Company Name & Address

Project Title

/Contract Number

Description of Project for

Which Reference is

Requested (Include type of work/trades performed)

Complexity of Work (circle) High Medium Low

Location of Work

Role on Project (circle) Prime Sub-contractor Consultant

Contract Amount $

Date of Award

Project Status

% Complete Scheduled

Completion Date

Actual Completion

Date

P15PS00203 – AZ MATOC Contract Page 3 of 8

Part 2

(To Be Completed by Person Providing Reference)

If the information provided in Part 1 is not accurate, please indicate and correct.

1. QUALITY OF WORK

Evaluate performance in complying with contract requirements, quality achieved and overall technical expertise demonstrated.

Excellent Quality

Above Average Quality

Average Quality

Below Average Quality

Unsuccessful or Experienced Significant Quality Problems & Issues

Remarks / Comments:

2. TIMELINESS OF PERFORMANCE

To what extent were contract performance requirements met? Consider contract performance period;

were submittals provided in a timely manner; timely completion of punch-list items; submission of close out documents, i.e., “as-built drawings”. Timely / satisfactory response to warranty issues, etc.

Completed Substantially Ahead of Schedule

Completed on Schedule with no Significant Time Delays

Completed on Schedule with Minor Delays Under Extenuating Circumstances

Routinely failed to Schedule Perform Requirements

P15PS00203 – AZ MATOC Contract Page 4 of 8

3. DOCUMENTATION QUALITY

To what extent were reports, submittals and other required documentation accurate, complete, comprehensive, and provided in a timely manner?

Excellent Quality

Above Average Quality

Average Quality

Below Average Quality

Unsuccessful / Extensive Quality Problems

4. COORDINATION

How well were sub-contractors, consultants, suppliers, and / or the labor force managed and coordinated? Or, if firm was a sub-contractor, how well did they respond to coordination efforts and work with other subs? Were there any problems and, if so, how were they handled and resolved?

Excellent

Above Average

Average

Below Average

Unsuccessful

P15PS00203 – AZ MATOC Contract Page 5 of 8

5. GENERAL MANAGEMENT PRACTICES

How appropriate and effective were the firm’s general management and business practices? Consider such things as; did they provide quality, experienced managers and supervisors, technical and administrative personnel for the duration of the project; were appropriate personnel promptly available when needed, and responded in a prompt and acceptable manner to resolve problems, did they provide comprehensive, accurate price proposals, etc.

Excellent

Above Average

Average

Below Average

6. OVERALL SAFETY PROGRAM

How well did the contractor manage the construction project as it relates to general safety? Discuss any safety issues that arose during the course of the project.

Excellent

Above Average

Average

Below Average

P15PS00203 – AZ MATOC Contract Page 6 of 8

7. BUDGET MANAGEMENT

How well did the contractor conform to the project budget? Did the contractor initiate unwarranted, unverifiable, change orders or change order requests, etc.?

Excellent

Above Average

Below Average

8. CLAIMS / LITIGATION

Was the contractor involved in any claims or litigation involving the project?

Yes (If “Yes”, please explain in remarks area below)

No

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9. OVERALL CUSTOMER SATISFACTION

To what extent were the end users satisfied with: Quality? Cost? Schedule?

Quality Cost Schedule

Exceptionally Satisfied

Highly Satisfied

Satisfied

Somewhat Dissatisfied (please explain)

Dissatisfied (please explain)

10. YOUR RECCOMENDATION

If given the opportunity and the choice, would you work with this contractor again?

Yes

No

Not Sure

P15PS00203 – AZ MATOC Contract Page 8 of 8

11. OTHER REMARKS / COMMENTS

Use the space below to provide other information related to the contractor's performance. This may include selection of sub-contractors / consultants, flexibility in dealing with contract challenges, payment issues, their overall concern for the client's interest (if applicable), project awards received, etc.