ATTACHMENT_I__Past_Performance_Questionnaire.pdf

(Presented for Information Only – Not to be completed by Offeror)

ATTACHMENT I

PAST PERFORMANCE RISK ASSESSMENT QUESTIONNAIRE

Please return this completed Questionnaire via e-mail to the Contract Specialist at robin.L.boateng@usace.army.mil Thank you for your assistance.

PAST PERFORMANCE QUESTIONNAIRE

Company/Agency Name Address Person Completing Survey Date Survey Completed Position Held in Reference to the Contract Length of Involvement in Contract Email Address Telephone Number Fax Number

Contractor Contract Title Contract Number Project Description Contract Type/Cost Award Date Original Contract Price Final Contract Price Explain Difference Percentage of Work Performed by Contractor

Roles and Responsibilities as Sub or Prime

Expected Completion Date Actual Completion Date Explain Differences mailto:lashonda.smith@usace.army.mil

1. Quality of Work:

a) How was the contractor’s compliance with applicable safety standards to protect personnel and company/agency resources?

Unsatisfactory Marginal Satisfactory Very Good Excellent

b) How was the contractor’s compliance with applicable labor standards?

Unsatisfactory Marginal Satisfactory Very Good Excellent

c) Was the contractor’s effort in Quality Control successful in ensuring quality workmanship on your project?

Unsatisfactory Marginal Satisfactory Very Good Excellent

d) Was the contractor committed to customer satisfaction?

Unsatisfactory Marginal Satisfactory Very Good Excellent

e) Overall rating for Quality of Work Unsatisfactory Marginal Satisfactory Very Good Excellent

2. Cost Controls:

a) Did the Contractor perform the required services at the contract price without adverse effect on performance?

Unsatisfactory Marginal Satisfactory Very Good Excellent

b) Did the contractor submit a fair and reasonable proposal when requested to perform additional work?

Unsatisfactory Marginal Satisfactory Very Good Excellent

c) If this contract is an indefinite delivery type contract (e.g., Multiple Award Environmental Contract, Task Order Contract, etc.), has the Contractor submitted competitive quotes on the individual orders issued under this contract?

Yes No N/A

d) Overall rating for Cost Controls Unsatisfactory Marginal Satisfactory Very Good Excellent

3. Timeliness of Performance:

a) Was the contractor timely in submitting schedules, reports, billings and other contract submittals?

Always Usually Sometimes Never N/A

b) Was the contractor timely in responding to requests for proposals for additional work?

Always Usually Sometimes Never N/A

c) Did the contractor complete the contract on time taking into account all excusable delays?

Yes No N/A

d) Was the contractor assessed any liquidated damages or deductions for late or nonperformance of required work?

If yes, please explain.

Yes No

e) Did the contractor exceed contractual requirements in relation to Timeliness of Performance in a way that was deemed beneficial to your agency?

Yes No N/A

If you answered No, indicate your reason by checking one of the following:

Contractor met the requirements, but did not exceed them Did not meet some of the requirements Did not meet requirements and recovery is not likely

f) Overall rating for Timeliness of Performance Unsatisfactory Marginal Satisfactory Very Good Excellent

4. Effectiveness of Management:

a) Did the contractor award subcontracts in a timely manner and properly manage them?

Always Usually Sometimes Never N/A

b) If applicable, did the contractor meet its small, small disadvantaged and women-owned business participation goals?

Yes No N/A

c) How would you rate the management of this firm as it relates to the completion of your contract and to the qualifications of its on-site personnel. Please explain.

Unsatisfactory Marginal Satisfactory Very Good Excellent

d) Describe the performance of the following personnel (if applicable)

1. Program Manger U M S VG E

2. Project Manager U M S VG E

3. Engineering/Technical U M S VG E

4. Quality Control Manager U M S VG E

5. Safety Officer U M S VG E

6. Superintendent U M S VG E

5. Customer Satisfaction:

a) Did the Contractor show reasonable and cooperative behavior and attention to customer satisfaction?

Yes No N/A

If you answered NO, please explain why:

6. Overall Rating of Contractor:

In summary, which of the following would you choose to best describe the overall quality of this firm’s past performance?

Unsatisfactory Marginal Satisfactory Very Good Excellent

7. Contact Information

Name of Person Completing Form Position Project Description Role of Contractor Phone No.

The information in this Questionnaire may be verified by Personnel from the U.S. Army Engineering and Support Center, Huntsville.