PAST_PERFORMANCE_QUESTIONNAIRE.pdf

PAST PERFORMANCE QUESTIONNAIRE

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

I. CONTRACT IDENTIFICATION

CONTRACTOR NAME: CONTRACT NO.:

CONTRACTOR ADDRESS: CONTRACT TYPE:

FIRM-FIXED-PRICE

COST REIMBURSEMENT

OTHER____________________________

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:

***Government Use Only – The following to be completed by Technical Evaluation Panel***

III. PAST PERFORMANCE RATING

Rating Scale: E = Exceeded minimum requirements/expectations M = Met minimum requirements/expectations D = Did not meet minimum requirements/expectations

1. QUALITY: (circle applicable rating)

a. Conformance with contract requirements E M D

b. Quality of workmanship (including subcontractors) E M D

c. General oversight by project manager and superintendent E M D

d. Coordination with and control of subcontractors E M D

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

f. Avoidance of accidents/safety violations E M D

2. TIMELINESS:

a. Adherence to project delivery schedules E M D

b. Submission of change proposals E M D

c. Response to technical direction and change orders E M D

d. Response to correction of identified problems E M D

e. Submission of timely/accurate/complete billings E M D

f. Submission of materials/other submittals E M D

3. BUSINESS RELATIONS:

a. Flexibility and cooperativeness in resolving problems E M D

b. Tenacity and innovativeness in resolving problems E M D

c. Relationships with subcontractors, including prompt payment E M D

d. End user was satisfied with services performed E M D