Past_Performance_Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

PART 1: INSTRUCTIONS. The company who has provided your name is participating in a Request for Proposal (RFP) with US Army Corps of Engineers, New Orleans District for Construction Management, primarily Quality Assurance Representative Services, primarily within the New Orleans District. We would greatly appreciate you taking the time to complete this form.

Please provide an honest assessment and immediately return to michelle.y.lappen@usace.army.mil

This completed form can also be sent directly to the address below:

US Army Corps of Engineers ATTN: Michelle Lappen (CEMVN-CT-W) 7400 Leake Avenue New Orleans, LA. 70118-3651 Tel: (504) 862-1612

PART 2: GENERAL INFORMATION.

1. Company's Name and Address (Contractor and/or subcontractor being evaluated)

NOTE: Offerer fill out before forwarding

2. Respondent Organization Name and Address

3. a. Evaluator’s Name _____________________________________________________

b. Evaluator’s involvement with contractor: ____________________________________

c. Title/Telephone Number:_________________________________________________

4. Contract Number _____________________________________________________________

5. Contract Value (Basic and Options) ______________________________________________

6. Award Date ________________________________________________________________

7. Contract or Task Order Completion Date (Include extensions): ________________________

8. Contract Type: Firm Fixed Price (FFP) ___________________________________________ Cost Plus Fixed Fee (CPFF)________________________________________ Cost Plus Award Fee (CPAF)_______________________________________

Other (Please Specify)_____________________________________________ Note: If an award fee contract, please provide a synopsis of available award fee pool and percentage of that pool awarded the contractor each evaluation period over the life of the contract.

9. Brief description of your contract requirements including type of work, degree of compexity, degree of self direction:

10. Additional data:

a. Approximate time contractor worked on project

b. Approximate value of work serviced by this contract

11. Type and extent of any subcontracting support:

12. How was the quality of work produced?

PART THREE: PERFORMANCE RATING. Please summarize performance in each of the rating factors.

Determine the rating that most nearly represents your experience with this company and indicate your assessment by placing the appropriate rating in the space provided. Please include descriptive comments to supplement ratings provided.

Ratings are defined below and should be used as a reference in assessing performance.

Rating “E” for Exceptional – Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Rating “G” for Very Good – Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Rating “S” for Satisfactory – Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Rating “M” for Marginal – Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Rating “U” for Unsatisfactory – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective action appear or were ineffective.

Rating "N/A" for Not Applicable - was not required to perform in this area.

____1. Preparation, use and quality of contractor’s internal Quality Control plan/program in identifying, correcting, and preventing problems.

____2. Were the safety rules, regulations and practices properly followed?

____3. How many accident/incident reports were filed for the duration of the contract?

____4. Was there an unusually high turnaround rate in management employees?

____5. Did the work teams report on time with proper working equipment?

____6. Was the contractor able to consistently maintain a qualified and experienced workforce to perform necessary services?

___7. Did the contractor respond timely and effectively to unexpected changes and emergency requirements?

___8. Did the contractor respond timely and effectively in resolving poor performance problems associated with its employees?

___9. How would you rate contractor’s adherence to contract/delivery schedules?

___10. Were reports & documentation submitted timely and in a professional manner?

___11. Prompt response to technical direction & change orders?

___12. Timely responses to resolving problems?

COMMENTS:

___15. Effectiveness of Project Manager

___16. Effectiveness of Management/Field Supervision.

___17. Recruiting, training and retention of staff maintained to service contract at required levels of performance ___a. Recruiting, training and retention of staff considered a management problem ___b. Recruiting, training and retention of staff considered a regional problem

___18. The problem, if any, experienced with recruiting, training and retention was in the staffing area(s) of

___19. The specific issues surrounding problems experienced with recruiting, training, and retention were__________________________________________________________________

COMMENTS:

Would you award another contract to this company? Why?

Yes No

ADDITIONAL COMMENTS (PRO AND CON)

PART FOUR: EVALUATOR'S CERTIFICATION:

I HEREBY CERTIFY THAT THE INFORMATION IN THIS FORM IS ACCURATE AND COMPLETE TO THE

BEST OF MY KNOWLEDGE.

Signature of Evaluator Date

Title of Evaluator