Attachment_5_-_Past_Performance_Questionnaire.docx

ATTACHMENT 5

PERFORMANCE QUESTIONNAIRE

R16PS00121 Silt Pumping Plant Modernization

Your assistance is requested in support of a source selection

Please complete this Questionnaire and email to:

USDOI Bureau of Reclamation Desired Response Date: July 20, 2016 Attn: Kris Brady (UC-857) 125 South State Street, Room 8100 email: kbrady@usbr.gov

TO BE COMPLETED BY OFFEROR

1. CONTRACTOR NAME & ADDRESS

2. CONTRACT NO.:

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

6. TYPE OF CONTRACT (fixed price, CMP, FPI, etc.):

7. DESCRIPTION OF CONTRACT REQUIREMENTS:

TO BE COMPLETED BY EVALUATING ORGANIZATION REPRESENTATIVE

8. EVALUATION:

a. Evaluator name, position (Project Manager/COR/Other) and organization:

b. Evaluator's Phone Number:

c. Months Performance Monitored by Evaluator:

Please circle response code for each topic (A-G) that best reflects your experience with this contractor.

N/O = Not Observed

A. Quality of Products and Services - Assess the contractor's conformance to contract requirements, specifications, and standards of good workmanship (e.g., technical, professional, environmental, or safety and health standards.

B. Performance - Assess the contractor's performance as the General Contractor or Architect/Engineer (as appropriate) for the project.

C. Technical Requirements - Assess the contractor's ability to fulfill the technical requirements of the contract.

D. Schedule - Assess the timeliness of the contractor against the schedule of activities.

E. Cost Control - Assess the contractor's ability to manage the contract budget and control costs.

F. Customer Satisfaction - Assess the contractor's responsiveness to customer concerns and "user friendliness".

G. Overall Assessment

Solicitation R16PS00121