Past Performance Questionnaire.docx

ATTACHMENT 1

DESIGN PAST PERFORMANCE ASSESSMENT WORKSHEET

(Limit each worksheet to no more than 3 pages)

DESIGN PROJECT #

Design Firm:

Project, Location & Contract Number:

Was this design performed by the division or unit of the company submitting as the design firm for this solicitation?

Owner:

For DB Projects only – Provide DB Contract Completion Date:

Explain Time Growth, if any:

General Scope of Construction:

Identify and describe the relevancies for this project compared to the scope of the solicitation. The Government will evaluate the information provided in making the relevancy determination.

Did any members of the proposed Design/Build team (firms, not individuals) have a role in this project? Identify the team members (by firm), their role in this project, and their proposed role in this solicitation.

ATTACHMENT 2

CONSTRUCTION PAST PERFORMANCE ASSESSMENT WORKSHEET

(Limit each worksheet to no more than 3 pages)

CONSTRUCTION PROJECT #_______

Offeror:

Project, Location, and Contract Number:

Was this project performed by the division or unit of the company submitting the offer for this solicitation?

Owner:

Owner’s Point of Contact for Reference:

Telephone:

Explain Cost Growth, if any:

Date of Award:

Explain Time Growth, if any:

General Scope of Construction and Offeror’s Role:

Work Your Company Self-Performed:

Extent and Type of Work You Subcontracted Out:

Identify and describe the relevancies for this project compared to the scope of the solicitation. The Government will evaluate the information provided in making the relevancy determination.

Did any members of the proposed Design/Build team (firms, not individuals) have a role in this project? Identify the team members (by firm), their role in this project, and their proposed role in this solicitation.

ATTACHMENT 3

USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

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:

How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

PAST PERFORMANCE QUESTIONNAIRE

Continued

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:

NOTE: USACE REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE COMPLETED QUESTIONNAIRE TO USACE WITH THEIR PROPOSAL, AND MAY DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON USACE SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY BE SUBMITTED DIRECTLY TO USACE. PLEASE CONTACT THE OFFEROR FOR USACE POC INFORMATION. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

PAST PERFORMANCE QUESTIONNAIRE

Continued ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

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.

Please circle the adjective rating which best reflects your evaluation of the contractor’s performance.

1. QUALITY:

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

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

3. CUSTOMER SATISFACTION:

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

E

VG

S

M

U

N

4. MANAGEMENT/ PERSONNEL/LABOR

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

VG

S

M

U

N

Source Selection Information – See FAR 2.101 and 3.104

CUI

g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes

E

VG

S

M

U

N

5. COST/FINANCIAL MANAGEMENT

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

E

VG

S

M

U

c) If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns)

VG

S

M

U

d) Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section.

Yes

No

e) 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

f) Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

Yes

No

6. SAFETY/SECURITY

a) To what extent was the contractor 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, etc.)

E

VG

S

M

U

N

7. GENERAL

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

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 pages if necessary):