105_P17PS00003_Performance_Questionnaire.docx
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- P17PS00003
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P17PS00003 Volume 1 - Past Performance Questionnaire Form (4 pages)
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PAST PERFORMANCE QUESTIONNAIRE
CONTRACT INFORMATION (Offeror to complete Blocks 1-4)
1. Contractor Information Firm Name: DUNs Number:
Address:
Phone Number:
Email Address:
Point of Contact: Contact Phone Number:
2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other (Explain) Percent of project work performed:
If subcontractor, who was the prime (Name/Phone #):
3. Contract Information Contract Number:
Delivery/Task Order Number (if applicable):
Contract Type: Firm Fixed Price Cost Reimbursement Other (Please specify):
Contract Title:
Contract Location:
Award Date (mm/dd/yy):
Contract Completion Date (mm/dd/yy):
Actual Completion Date (mm/dd/yy): Explain Differences:
Original Contract Price (Award Amount):
Final Contract Price (to include all modifications, if applicable):
Explain Differences:
| 4. Project Description: | |||
| Complexity of Work | High | Med | Routine |
How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)
CLIENT INFORMATION (Client to complete Blocks 5-8)
5. Client Information Name: Title:
Phone Number: Email Address:
6. Describe the client’s role in the project:
7. Date Questionnaire was completed (mm/dd/yy):
8. Client’s Signature:
NPS PMIS No. GATE-200607B RFP No. P17PS00003 Relocate Staten Island Unit Maintenance Facility Instructions: Offeror to complete Blocks 1-4. Client to complete Blocks 5-8 and questionnaire. NPS REQUESTS THAT THE CLIENT SUBMIT DIRECTLY BACK VIA EMAIL ATTACHMENT THE ENTIRE COMPLETED QUESTIONNAIRE TO BOTH ALAN_STORMONT@NPS.GOV AND ALBERT_OMARA@NPS.GOV. THE OFFEROR WILL SUBMIT BLOCKS 1-4 OF THE QUESTIONNAIRE TO NPS WITH THEIR TECHNICAL PROPOSAL. THE NPS RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.
ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE
RATING DEFINITION NOTE
| (E) Exceptional |
| Performance meets contractual requirements and exceeds many to the Government/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective. |
| An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified. |
| (VG) Very Good |
| Performance meets contractual requirements and exceeds some to the Government’s/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner. There should have been no significant weaknesses identified. |
| (S) Satisfactory |
| Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. |
There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.
| (M) Marginal |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented. |
| A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government/Owner. |
| (U) Unsatisfactory |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor's corrective actions appear or were ineffective. |
| An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. |
| (N) Not Applicable |
| No information or did not apply to your contract |
| Rating will be neither positive nor negative. |
NPS PMIS No. GATE-200607B RFP No. P17PS00003 Relocate Staten Island Unit Maintenance Facility
Contractor Information (Firm Name):
Client Information (Name):
TO BE COMPLETED BY CLIENT
PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.
1. QUALITY:
| a) Conformance with contract requirements | |||||
| E | VG | S | M | U | N |
| b) Quality of workmanship (including subcontractors) | |||||
| E | VG | S | M | U | N |
| c) Adequacy of contractor Quality Control Plan including coordination with and control of subcontractors | |||||
| E | VG | S | M | U | N |
| d) Adequacy of materials, submittals, QC testing, and As-Builts and use of specified materials | |||||
| E | VG | S | M | U | N |
2. SCHEDULE/TIMELINESS OF PERFORMANCE:
| a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below) | |||||
| E | VG | S | M | U | N |
| b) Adequacy of initial and revised Progress Schedules and adherence to project delivery schedules | |||||
| E | VG | S | M | U | N |
| c) Submission of materials/other submittals, change proposals, requests for information, and required documentation | |||||
| E | VG | S | M | U | N |
| d) Submission of timely/accurate/complete invoices | |||||
| E | VG | S | M | U | N |
| e) Response to technical direction, change orders, correction of identified problems, resolution of delays | |||||
| E | VG | S | M | U | N |
3. CUSTOMER SATISFACTION:
| a) To what extent were the end users satisfied with the project services provided? | |||||
| E | VG | S | M | U | N |
| b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; business-like and communication)? | |||||
| E | VG | S | M | U | N |
| c) To what extent was the contractor cooperative, responsive, business-like, and concerned with the interests of the customer? | |||||
| E | VG | S | M | U | N |
| d) Overall customer satisfaction – would you hire or work with this firm again? (Please explain below) | |||||
| E | VG | S | M | U | N |
4. EFFECTIVENESS OF MANAGEMENT/ PERSONNEL/LABOR
| a) General effectiveness of on-site management – project manager and superintendent? | |||||
| E | VG | S | M | U | N |
| b) Effectiveness of management and coordination and control of subcontractors, suppliers, materials, and/or labor force? | |||||
| E | VG | S | M | U | N |
| c) Ability to hire, apply, and retain a qualified workforce for this project and manage resources including site clean-up | |||||
| E | VG | S | M | U | N |
| d) Knowledge/expertise demonstrated by contractor and subcontractor personnel | |||||
| E | VG | S | M | U | N |
| e) Utilization of Small Business concerns | |||||
| E | VG | S | M | U | N |
| f) Implementation of Subcontracting Plans | |||||
| E | VG | S | M | U | N |
| g) Professional conduct of all personnel on the project | |||||
| E | VG | S | M | U | N |
| h) Effectiveness of overall management (including ability to effectively lead, manage and control the program) | |||||
| E | VG | S | M | U | N |
5. COST CONTROL /FINANCIAL MANAGEMENT
| a) Ability to meet the terms and conditions within the contractually agreed price(s)? | |||||
| E | VG | S | M | U | N |
| b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client | |||||
| E | VG | S | M | U | N |
| c) Adequacy of Contractor’s accounting system for management and tracking of costs? (Please explain in Remarks section.) | |||||
| E | VG | S | M | U | N |
6. COMPLIANCE WITH REGULATIONS AND SAFETY STANDARDS
| a) Adequacy and implementation of Safety Plan and avoidance of accidents/safety violations | |||||
| E | VG | S | M | U | N |
| b) Compliance with labor laws and regulations with specific attention to the Davis-Bacon Act, EEO requirements, and proper completion and submission of payrolls | |||||
| E | VG | S | M | U | N |
| 7. OVERALL RATING FOR THE WORK PERFORMED ON THIS PROJECT BY THIS CONTRACTOR | |||||
| E | VG | S | M | U | N |
Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk.
(please attach additional pagesif necessary):
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