SSA Annex Chiller Past Performance Questionnaire.pdf

APPENDIX C

OWNER/PROJECT REPRESENTATIVE EVALUATION COVER SHEET

To be completed by the Offeror:

Offeror being evaluated: ________________________________

Name, Location, and Description of Project:

Original Contract Award Amount: $____________________

Final Contract Amount: $ ____________________

Project Completion Date ____________________

Evaluator 1’s Name, Organization Name, Title, Address, Email Address, and Telephone Number

Evaluator 2’s Name, Organization Name, Title, Address, Email Address, and Telephone Number

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION SEE FAR 3.104

OWNER/PROJECT REPRESENTATIVE EVALUATION SHEET

For each of the questions appearing on the attached sheets, please place an “X” next to the statement that best represents your evaluation in response to the subject questions. Please note any comments that will add value to your marked response.

General Rating Descriptions:

Rating Scoring Description

Superior (5) The Offeror’s past performance significantly exceeded the evaluation standard.

There were no deficiencies or significant weaknesses and there was a very low risk of unsuccessful contract performance.

Highly Successful (4)

The Offeror’s past performance met and to some extent exceeded the evaluation standard. There were no deficiencies or significant weaknesses and there was a low risk of unsuccessful contract performance.

Acceptable (3) The Offeror’s past performance met the evaluation standard. There were no deficiencies. Weaknesses were readily correctible. There was a moderate risk of unsuccessful contract performance.

Marginal (2) The Offeror’s past performance did not fully meet the evaluation standard.

Deficiencies and/or significant weaknesses existed which may or may not have been correctable. There was a moderate to high risk of unacceptable contract performance.

Poor (1) The Offeror’s past performance failed to meet the evaluation standard. There were major deficiencies and/or significant weaknesses that were not readily correctable.

There was an unacceptably high risk of unsuccessful contract performance.

Schedule Management

1. Did the Offeror successfully manage the project schedule and complete the project on time?

____ 5 - Offeror proactively managed schedule and completed project prior to the originally scheduled completion date.

____ 4 - Offeror proactively managed schedule and completed project by original scheduled completion date.

____ 3 – Offeror completed project by original scheduled completion date.

____ 2 - Offeror reactively managed schedule and/or completed project within agreed to extended completion date.

____ 1- Offeror failed to meet project completion date.

Comments:

SCORE FOR THIS SECTION:

(Scale of 1 to 5 with 5 being the highest) __________ Initials_____

Scope Management

2. Did the Offeror successfully manage the project scope and respond appropriately to changes and/or quality concerns?

____ 5 - Offeror proactively managed scope (including changes) and exceeded quality expectations ____ 4 - Offeror proactively managed scope (including changes) and met quality expectations ____ 3 – Offeror managed project’s original scope and met quality expectations ____ 2 - Offeror reactively managed scope (including changes) and/or did not meet quality expectations ____ 1- Offeror failed to meet project scope and/or quality expectations

Comments:

SCORE FOR THIS SECTION:

(Scale of 1 to 5 with 5 being the highest) __________ Initials ________

Budget Management

3. How successful was the offeror in managing the project budget?

____ 5 - Offeror proactively managed budget (including changes) and delivered project under budget ____ 4 - Offeror proactively managed budget (including changes) and delivered project within budget ____ 3 – Offeror managed project’s original budget and delivered project within budget ____ 2 - Offeror reactively managed budget (including changes) and/or delivered project over budget ____ 1- Offeror failed to manage project budget and/or delivered project over budget

Comments:

SCORE FOR THIS SECTION:

(Scale of 1 to 5 with 5 being the highest) __________ Initials ________

Risk Management

4. How successful was the offeror in managing the project risk while maintaining quality?

____ 5 - Offeror proactively managed risk and exceeded quality expectations ____ 4 - Offeror proactively managed risk and met quality expectations ____ 3 – Offeror managed project’s risk and met quality expectations ____ 2 - Offeror reactively managed risk and/or did not meet quality expectations ____ 1- Offeror failed to manage risk and/or did not meet quality expectations

Comments:

SCORE FOR THIS SECTION:

(Scale of 1 to 5 with 5 being the highest) __________ Initials ________

OVERALL SCORE:

(Scale of 1 to 5 with 5 being the highest) __________ Initials ________

Additional Comments:

Would you award a contract to this firm again for similar work?_____yes ____no

Why or why not:

Evaluated By: __________________________ Signature

Name and Title: __________________________ Organization: __________________________