Questionnaire Design-Builder in Word Format.doc

Part III Past Performance Questionnaire

Note: Completed questionnaires shall be considered confidential information and may not be seen or reviewed by the contractor/Offeror. Mail or email completed questionnaires directly to:

Attention: Beverly Carey, Contracting Officer

General Services Administration

Design and Construction Division (8PC)

Building 41, Denver Federal Center

Lakewood, CO 80225

Beverly.Carey@gsa.gov

Name:

Company:

Role/position during construction:

Current Telephone No.:

(Use this cover sheet for each past performance questionnaire submitted)

USE THIS QUESTIONNAIRE FOR THE DESIGN-BUILDER

CONTRACTOR PERFORMANCE EVALUATION QUESTIONNAIRE

When filled in this document is source selection sensitive information iaw FAR 3.104 u.s. General Services administration

Public BuildingS service

Rocky MOUNTAIN REGION

OVERVIEW

The Offeror shown below is submitting qualifications for Design/Build services on the Tier III Data Center New Construction project at Denver Federal Center in Lakewood, Colorado, and provided your name as a customer reference. Part of our evaluation process requires information on the Offeror’s past performance. Your participation is important to us and responses are required by October 29, 2009 , 2:00 PM (Mountain Time) for inclusion in our evaluation. Your assistance is greatly appreciated.

SECTION 1: Contract Identification

To be completed by the Offeror and provided to the customer referenced Name of Offeror being evaluated: _______________________________________

Project Number/Title: _________________________________________________

Project Location:_____________________________________________________

Project Description: ___________________________________________________

Project Award Amount: $_______________________________________________

Project Final Dollar Amount: $___________________________________________

Year Completed: _________ Project Manager: _________________________

SECTION 2: Respondent Identification

Name of Evaluator: ________________________________________________

Relation to Contract/Project: ___________________________________________

Company Name: ____________________________________________________

Phone Number (Commercial/DSN): ____________________________________

Email Address: ____________________________________________________

USE THIS QUESTIONNAIRE FOR THE DESIGN-BUILDER

SECTION 3: Rating of Offeror

To be completed by the customer:

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

Score Performance Level

EXCELLENT - The contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s or customer’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD- The contractor’s performance meets or exceeds contractual requirements to the Government’s or customer’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

ACCEPTABLE – The contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the contractor appears, or were, satisfactory.

MARGINAL – Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

UNACCEPTABLE – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N NOT APPLICABLE - Unable to provide a score.

Management

Professional conduct

Cooperation/responsiveness –timely, solicits feedback, suggests alternatives

Offeror is easy to work with, friendly, courteous

Oversight of project management/superintendents

Quickly/professionally resolves issues/disputes

Review/resolution of subcontractors issues

Clear line of supervision on construction site, effective

Followed and maintained project budget

Implementation of Subcontracting Plan (applicable to large businesses)

USE THIS QUESTIONNAIRE FOR THE DESIGN-BUILDER

Construction

Compliance with laws and regulations

Coordination\control of subcontractors – ensures adherence to work schedule

Resource Management – maintains good construction pace/work environment

Site Management (i.e. materials properly staged/stored, job site cleanliness)

Adequacy & adherence of initial progress schedule/submission of revisions

Resolution of Delays

Timely completion of punch-list items

Adequacy and implementation of Safety Plan

Use of specified/equal materials

Identification/correction of deficient work in a timely manner

Quality of workmanship

Adequacy of QC Testing – provides all tests as required

Closeout/Warranty

Submission of required documentation

Timeliness of submissions

Adequacy of As-Builts - maintains accurate red line drawings on site per specs

Format of closeout documentation

Warranty response

Correction of noted deficiencies

SECTION 4: Narrative Summary

Please indicate in writing any additional comments you have of the Offeror and suggestions you may have concerning the following categories:

Strengths of performance: ____________________________________________________________________

Weaknesses of performance: __________________________________________________________________

Additional Thoughts: ________________________________________________________________________

USE THIS QUESTIONNAIRE FOR THE DESIGN-BUILDER

SECTION 5: Submission

Thank you for taking the time to fill out this questionnaire. As stated above, when filled in this document is source selection sensitive information IAW FAR 3.104. When completed please mail, hand-deliver, or email directly to:

U.S. General Services Administration

Public Buildings Services

P.O. Box 25546

Denver, Colorado 80225-0546 PHONE: (303) 236-8000, Ext. 5257 ATTN: Beverly Carey (8PSD) EMAIL: beverly.carey@gsa.gov Respondent Signature: _________________________________________ Date: ______________________ �Provide Date