W912DW23R0S1T_AM0001 PPQ.pdf

Amendment 0001

QUALITY OF PAST PERFORMANCE SURVEY FORM FOR DESIGN FIRMS (PPQ)

A. GENERAL INFORMATION:

Company Name & UEI: ____________________________________________________________

Address: _______________________________ Telephone Number: ________________________

________________________________________ Point of Contact: _________________________

Project Name and Location:_________________________________________________________

Project Contract Number:___________________________________________________________

Project Start and Completion Date: ___________________________________________________

Contractor Performed as the Design Firm (Prime), the Design Sub-consultant

B. CLIENT INFORMATION:

Name of Client: ________________________ Title: ____________________________________

Address: _______________________________ Telephone Number: _______________________

Client’s Signature: _______________________________________________________________

C. PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation.

5 EXCEPTIONAL

Performance significantly exceeds contract requirements to the Government’s benefit.

4 VERY GOOD

Performance exceeds contract requirements to the Government’s benefit.

3 SATISFACTORY Performance meets contractual requirements.

2 MARGINAL Performance is deficient in meeting contractual requirements.

1 UNSATISFACTORY Performance does not meet contractual requirements.

NA NOT APPLICABLE

No record of past performance, the record is inconclusive, or this did not apply.

PAST PERFORMANCE SURVEY FORM

The Design Firm:

1.

Provided experienced design managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

NA 1 2 3 4 5

2.

Demonstrated ability to hire, maintain, and replace, if necessary, qualified design personnel during the contract period.

NA 1 2 3 4 5

3.

Delegated authority to project design managers and supervisors commensurate with contract requirements.

NA 1 2 3 4 5

4.

Provided technically correct designs, code compliant, and complying with the contract requirements.

NA 1 2 3 4 5

5. Followed approved quality control plan for design. NA 1 2 3 4 5

6.

Provided effective quality control and/or technical review procedures to meet contract requirements. Responsive the customer review comments.

NA 1 2 3 4 5

7.

Corrected design errors or conflicting design information in timely manner and pursuant to their quality control procedures.

NA 1 2 3 4 5

Amendment 0001

8. Provided timely responses to review comments. NA 1 2 3 4 5

9. Identified risks/problems as they occurred. NA 1 2 3 4 5

10. Suggested alternative approaches to problems. NA 1 2 3 4 5

11. Displayed initiative to solve problems. NA 1 2 3 4 5

12. Developed realistic progress schedules. NA 1 2 3 4 5

13. Met established project schedules. NA 1 2 3 4 5

14.

Provided quality shop drawing reviews during the construction phase of the project.

NA 1 2 3 4 5

15. Was responsive to contract changes. NA 1 2 3 4 5

16.

Design Firms interaction with the Owner when developing project requirements.

NA 1 2 3 4 5

17.

Provided accurate and complete cost proposals including all aspects of work required.

NA 1 2 3 4 5

18.

Would you award another contract to this design firm? If not, explain in “remarks.”

YES NO

19. OVERALL EVALUATION OF DESIGN FIRM’S PERFORMANCE. NA 1 2 3 4 5

Remarks:________________________________________________________________________

Client’s Signature & Date: ___________________________________________________