6_Past_Performance_Questionnaire.doc
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- Sandy Hook WWTP - Resiliency Measures Federal contract opportunity
- Solicitation number
- P16PS00687
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Past Performance Questionnaire
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PAST PERFORMANCE QUESTIONNAIRE
INSTRUCTIONS: Offeror to complete Sections I and II and transmit questionnaire to reference listed in Section II
Reference to complete Sections III and IV and transmit back to Contracting Officer (see contact information at bottom of form)
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/CLIENT (CUSTOMER) 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 |
| E |
G S M U
| b. Quality of workmanship (including subcontractors) |
| E |
G S M U
| c. General oversight by project manager and superintendent |
| E |
G S M U
| d. Coordination with and control of subcontractors |
| E |
G S M U
| e. Compliance with Davis-Bacon wage rate and labor usage requirements |
| E |
G S M U
| f. Avoidance of accidents/safety violations |
| E |
G S M U
| g. Ability to work in remote locations, if applicable |
| E |
G S M U
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. Ability to meet project schedule milestones |
| E |
G S M U
| g. 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. Relationships with owner’s representative |
| E |
G S M U
| e. End user was satisfied with services performed |
| E |
G S M U
IV. COMMENTS
Provide any additional comments for items in Section III
| Item No. |
| Comment |
POC SIGNATURE/DATE:
Please provide contact information where you may be reached during normal business hours:
National Park Service/ Denver Service Center Contact Information:
Contracting Officer: <insert CO Name> Contract Specialist: <insert CS Name>
MAILING ADDRESS:
National Park Service / Denver Service Center (DSC-CS)
ATTN: Contracting Officer 12795 West Alameda Parkway
Lakewood, CO 80228
OR EMAIL FORM TO: <insert CO>@nps.gov and <insertCS>@nps.gov
PAGE
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