Past_Performance_Questionnaire_-_DRTO.pdf

I. CONTRACT IDENTIFICATION

CONTRACTOR NAME: CONTRACT NO:

CONTRACTOR ADDRESS: CONTRACT TYPE:

FIRM-FIXED-PRICE

COST REIMBURSEMENT

OTHER: (specify)

ACTIVE COMPLETED

ROUTINE COMPLEX

DATES OF PERFORMANCE: AWARD AMOUNT: $

TOTAL WITH MODS $

PROJECT DESCRIPTION:

II. AGENCY (CUSTOMER) IDENTIFICATION

AGENCY (CUSTOMER) NAME:

POC NAME/TITLE/PHONE:

III. PAST PERFORMANCE RATING

Rating Scale: E = Excellent. Considerably surpassed requirements/expectations.

G = Good. Surpassed requirements/expectations.

S = Satisfactory. Met requirements/expectations M = Marginal. Met some requirements/expectations U = Unsatisfactory. Did not meet requirements/expectations

1. QUALITY: (Circle applicable rating)

a. Conformance with contract requirements

b. Quality of workmanship (including subcontractors)

c. General oversight by project manager and superintendent

d. Coordination with and control of subcontractors

e. Compliance with Davis-Bacon wage rate and labor usage requirements

f. Avoidance of accidents/safety violations

PAST PERFORMANCE QUESTIONNAIRE SOLICITATION P15PS00382

REPAIR BASTIONS AT FORT JEFFERSON - DRTO 149152A

(COMPLETE SECTIONS I AND II AND SUBMIT WITH THE TECHNICAL PROPOSAL)

E

G

G

S

S

M

M

U

U

E

E

E

G

G

G

S

S

S

M

M

M

U

U

G

S

M

2. TIMELINESS:

a. Adherence to project delivery schedules E G S M U

b. Submission of change proposals E G S M U

c. Response to technical direction and change orders E G S M U

d. Response to correction of identified problems E G S M U

e. Submission of timely/accurate/complete billings E G S M U

f. Submission of materials/other submittals E G S M U

3. BUSINESS RELATIONS:

a. Flexibility and cooperativeness in resolving problems E G S M U

b. Tenacity and innovativeness in resolving problems E G S M U

c. Relationships with subcontractors, including prompt payment E G S M U

d. End user was satisfied with services performed E G S M U

IV. COMMENTS

Required for ratings of C (Considerably Surpassed Requirements) or D (Did Not Meet Requirements)

Item No. Comment

Technical Evaluation Panel Member: Date: