Past Performance Reference Check.pdf

PAST PERFORMANCE REFERENCE CHECK

I. YOU ARE BEING CONTACTED FOR A REFERENCE REGARDING THE PERFORMANCE OF

Contractor:

City and State:

Type of Contract:

Please fill out items II – IV.

II. NAME OF COMPANY/ GOVERNMENT AGENCY PROVIDING REFERENCE:

Name and Title of Individual Providing Reference Responses:

Signature: __________________________________________________Date: ______________________

Phone Number: ________________________Email:___________________________________________

Does the information in Section I above accurately describe your project and or contract, if not, please explain.

III. PAST PERFORMANCE QUESTIONNAIRE

Use the following adjective ratings and definitions in your evaluation of the Key Personnel’s performance.

RATING

DEFINITION

NOTE

(E) Exceptional Performance meets requirements and exceeds many to the Government/Owner’s benefit. The performance being assessed was accomplished with few minor problems for which corrective actions taken by the Key Personnel was highly effective.

An Exceptional rating is appropriate when the Key Personnel 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 requirements and exceeds some to the Government’s/Owner’s benefit. The performance assessed was accomplished with some minor problems for which corrective actions taken by the Key Personnel were effective.

A Very Good rating is appropriate when the Key Personnel 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 requirements. The performance had some minor problems for which corrective actions taken by the Key Personnel appear or were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the Key Personnel recovered from without impact to the Government/Owner. There should have been NO significant weaknesses identified.

(L) Less than Satisfactory Performance does not meet some or most requirements. The performance being assessed reflects a serious problem for which the Key Personnel did not identify corrective actions.

The Key Personnel's proposed actions appear only marginally effective or were not fully implemented.

A Less than Satisfactory rating is appropriate when multiple significant events occurred that the Key Personnel had trouble overcoming and which impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes a less than satisfactory rating.

(N) Not Applicable No information or did not apply to your work with the Key Personnel.

Rating will be neither positive nor negative.

Past Performance Reference

Instructions: Please select the adjective rating that best reflects your evaluation of the Key Personnel’s performance.

1. QUALITY:

E VG S L N

(a) Quality of technical data/report preparation efforts including but not limited to schedule, submittals, shop drawings, manuals, as-builts.

(b) Ability to meet quality standards specified for technical performance, including but not limited to, materials, workmanship, protection of property, clean up.

(c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance.

(d) Adequacy/effectiveness of quality control program and adherence to quality assurance requirements (without adverse effect on performance).

(e) What could have improved your ratings for Quality?

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

(a) Compliance with delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below.)

(b) Rate the Key Personnel’s use of available resources to accomplish tasks identified in the contract.

(c) Rate the Key Personnel’s time commitment to the project.

(d) What could have improved your ratings for Schedule/Timeliness of Performance?

3. CUSTOMER SATISFACTION:

(a) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports, businesslike and communication).

(b) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer?

(c) Timeliness of communications with you, such as keeping you informed of the project status, advising you of issues or concerns, etc.

(d) Overall customer satisfaction.

(e) What could have improved your ratings for Customer Satisfaction?

4. MANAGEMENT/ PERSONNEL/LABOR

(a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force?

(b) Ability to hire, apply, and retain a qualified workforce to this effort and compliance with applicable labor laws.

(c) Knowledge/expertise demonstrated by contractor personnel.

(d) Ability to simultaneously manage work items with multiple disciplines and trades.

(e) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to changes.

(f) Effectiveness of overall project management (or design), including ability to effectively lead, manage and control the program.

(g) What could have improved your ratings for Management/Personnel/Labor?

5. COST/FINANCIAL MANAGEMENT

(a) Ability to meet the terms and conditions within the contractually agreed price(s)?

(b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client.

(c) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? (Indicate if show cause or cure notices were issued, or any default action in comment section below.)

Yes _____ No _____

(d) Were any claims or mechanics liens filed in connection with this project? (If yes, please explain in the comment section below.)

(e) Have there been any indications that the contractor has had any financial problems? (If yes, please explain in the comment section below.)

(f) What could have improved your ratings for Cost/Financial Management?

IV. ADDITIONAL COMMENTS

Submit the completed form to via email, send it akubiak@ushmm.org.

6. SAFETY/SECURITY/ENVIRONMENTAL

(a) To what extent was the Key Personnel able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, environmental compliance, etc.).

(b) Key Personnel complied with all security requirements for the project and personnel security requirements.

(c) For the person named above and for his/her employer, how satisfied were you with their ability to comply with environmental laws, regulations and policies?

(d) Were there any violations of law or regulations (specifically, but not limited to, environmental or safety violations) with respect to their performance, or were there any other serious performance issues? (If yes, please explain in the comment section below.)

(e) What could have improved your ratings for Safety/Security?

7. GENERAL

(a) Ability to successfully respond to emergency situations and resolve contractual and project issues.

(b) Compliance with contractual terms/provisions (If there were specific issues, please explain in the comments sections below

(c) In summary, provide an overall rating for the work performed by this contractor.

8. SUMMARY

Would you hire or work with this person again? (If no, please explain in the comments section below.)