DD2626.pdf

PERFORMANCE EVALUATION

(CONSTRUCTION)

1. NUMBER

2.

FOR OFFICIAL USE ONLY (WHEN COMPLETED)

IMPORTANT: Be sure to complete Part III - Evaluation of Performance Elements on reverse.

PART I - GENERAL CONTRACT DATA

3. EVALUATION (X one)

INTERIM (List percentage

4. FOR DEFAULT

%) FINAL AMENDED

5. (Name, Address, and ZIP Code) 6.a. PROCUREMENT METHOD (X one)

SEALED BID NEGOTIATED

b. OF CONTRACT (X one)

FIRM FIXED PRICE COST REIMBURSEMENT

OTHER (Specify)

7. LOCATION OF WORK

8. PERCENT OF SUBCONTRACTING

9. FISCAL DATA

10. SIGNIFICANT

DATES

a. BASIC

CONTRACT

b. AMOUNT OF

MODIFICATIONS

c.

DAMAGES ASSESSED

d.

CONTRACTOR

a. AWARD b.

COMPLETION DATE

c.

COMPLETION DATE

d.

ACCEPTED

PART II - PERFORMANCE EVALUATION OF CONTRACTOR

11. OVERALL RATING (X appropriate block)

OUTSTANDING ABOVE AVERAGE SATISFACTORY MARGINAL UNSATISFACTORY (Explain in Item 20 on reverse)

12. EVALUATED BY

a. ORGANIZATION (Name and Address (Include ZIP Code)) b. (Include Area

Code)

c. AND TITLE d. e.

13. EVALUATION REVIEWED BY

a. ORGANIZATION (Name and Address (Include ZIP Code)) b. (Include Area

Code)

c. AND TITLE d. e.

14. AGENCY USE (Distribution, etc.)

CONTRACT

CEC NUMBER

TYPE OF TERMINATED

CONTRACTOR

TYPE

DESCRIPTION AND

TYPE AND

AMOUNT OF TOTAL LIQUIDATED NET AMOUNT PAID

DATE OF ORIGINAL CONTRACT REVISED CONTRACT DATE WORK

TELEPHONE NUMBER

NAME SIGNATURE DATE

TELEPHONE NUMBER

NAME SIGNATURE DATE

DD FORM 2626, JUN 94 EXCEPTION TO SF 1420 APPROVED BY GSA/IRMS 6-94

FOR OFFICIAL USE ONLY (WHEN COMPLETED)

PART III - EVALUATION OF PERFORMANCE ELEMENTS

N/A = NOT APPLICABLE O = OUTSTANDING A = ABOVE AVERAGE S = SATISFACTORY M = MARGINAL U = UNSATISFACTORY

15. QUALITY CONTROL N/A O A S M U 16. EFFECTIVENESS OF MANAGEMENT N/A O A S M U

a. QUALITY OF WORKMANSHIP a. COOPERATION AND RESPONSIVENESS

b. ADEQUACY OF THE CQC PLAN b. MANAGEMENT OF RESOURCES/

PERSONNELc. IMPLEMENTATION OF THE CQC PLAN c. COORDINATION AND CONTROL OF

SUBCONTRACTOR(S)d. QUALITY OF QC DOCUMENTATION d. ADEQUACY OF SITE CLEAN-UP

e. STORAGE OF MATERIALS e. EFFECTIVENESS OF JOB-SITE SUPERVISIONf. ADEQUACY OF MATERIALS

g. ADEQUACY OF SUBMITTALS f. COMPLIANCE WITH LAWS AND REGULATIONSh. ADEQUACY OF QC TESTING

i. ADEQUACY OF AS-BUILTS g. PROFESSIONAL CONDUCT

j. USE OF SPECIFIED MATERIALS h. REVIEW/RESOLUTION OF

SUBCONTRACTOR'S ISSUESk. IDENTIFICATION/CORRECTION OF

DEFICIENT WORK IN A TIMELY

MANNER

i. IMPLEMENTATION OF

SUBCONTRACTING PLAN

17. TIMELY PERFORMANCE 18. COMPLIANCE WITH LABOR

STANDARDSa. ADEQUACY OF INITIAL PROGRESS

SCHEDULE a. CORRECTION OF NOTED DEFICIENCIES

b. ADHERENCE TO APPROVED

SCHEDULE

b. PAYROLLS PROPERLY COMPLETED

AND SUBMITTED

c. RESOLUTION OF DELAYS c. COMPLIANCE WITH LABOR LAWS

AND REGULATIONS WITH SPECIFIC

ATTENTION TO THE DAVIS-BACON

ACT AND EEO REQUIREMENTS

d. SUBMISSION OF REQUIRED

DOCUMENTATION

e. COMPLETION OF PUNCHLIST

ITEMS

19. COMPLIANCE WITH SAFETY

STANDARDS

f. SUBMISSION OF UPDATED AND

REVISED PROGRESS SCHEDULES

a. ADEQUACY OF SAFETY PLAN

b. IMPLEMENTATION OF SAFETY PLAN

g. WARRANTY RESPONSE c. CORRECTION OF NOTED DEFICIENCIES

20. REMARKS (Explanation of unsatisfactory evaluation is required. Other comments are optional. Provide facts concerning specific events or actions to justify the evaluation. These data must be in sufficient detail to assist contracting officers in determining the contractor's responsibility. Continue on separate sheet(s), if needed.)

DD FORM 2626 (BACK), JUN 94