Performance Evaluation
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1
2A-E CONTRACTOR I.D. NUMBER
(For ACASS use only)
PERFORMANCE EVALUATION
1. A-E CONTRACT NUMBER
(ARCHITECT-ENGINEER)
2. CONSTRUCTION CONTRACT NUMBER
IMPORTANT: Be sure to complete back of form. If additional space is necessary for any item, use Remarks section on back.
4. PROJECT
5. DELIVERY
3. TYPE OF EVALUATION
NUMBER
ORDER NO.(S)
a. PHASE OF COMPLETION
b. COMPLETION (X one)
c. X IF APPLICABLE
(if applicable)
TERMINATION
ENGINEERING
CONSTRUCTION
INTERIM (
%)
FINAL
DESIGN
(Explain in Remarks)
SERVICES
6. NAME AND ADDRESS OF A-E CONTRACTOR
7a. PROJECT TITLE AND LOCATION
7b. DESCRIPTION OF PROJECT IF NOT EXPLAINED BY TITLE
8. NAME, ADDRESS AND PHONE NUMBER OF OFFICE RESPONSIBLE FOR:
a. SELECTION OF A-E CONTRACTOR
b. NEGOTIATION/AWARD OF A-E CONTRACT
c. ADMINISTRATION OF A-E CONTRACT
d. ADMINISTRATION OF CONSTRUCTION CONTRACT
9. A-E CONTRACT DATA
(Items 9d thru 9g are not applicable during construction unless there are modifications to the A-E contract.)
a. TYPE OF WORK (Design, study, etc.)
b. TYPE OF CONTRACT
INDEFINITE DELIVERY/INDEFINITE QUANTITY (ID/IQ)
FIRM FIXED-PRICE
TASK ORDER UNDER ID/IQ
COST-REIMBURSEMENT
OTHER (Specify)
c. PROJECT COMPLEXITY
d. CONTRACT OR TASK ORDER AMOUNT
(1) INITIAL FEE
(3) TOTAL FEE
DIFFICULT
ROUTINE
(2) CONTRACT OR TASK ORDER MODIFICATIONS
AMOUNT
NO.
0.00
$
$
$
f. NEGOTIATED CONTRACT OR TASK ORDER
e. CONTRACT OR TASK ORDER AWARD DATE
g. ACTUAL CONTRACT OR TASK ORDER
COMPLETION DATE (or number of days)
COMPLETION DATE (or number of days)
(Including extensions)
10. CONSTRUCTION CONTRACT DATA
(Not applicable at completion of design or engineering services not involving construction.)
(2) A-E ESTIMATE FOR BID ITEMS
(1) AUTHORIZED CONSTRUCTION COST
(3) AWARD AMOUNT
AWARDED
a. CONSTRUCTION COSTS
$
$
$
b. DATA AT TIME OF CONSTRUCTION COMPLETION
NUMBER
TOTAL COST
)
(Completion date
$
(1) CONSTRUCTION MODIFICATIONS
(2) CONSTRUCTION MODIFICATIONS ARISING FROM DESIGN
$
DEFICIENCIES
$
$
11. A-E LIABILITY
NONE
UNDETERMINED
PENDING
SETTLEMENT
12. OVERALL RATING
13. RECOMMENDED FOR FUTURE CONTRACTS?
EXCEPTIONAL
SATISFACTORY
UNSATISFACTORY
YES
CONDITIONALLY
VERY GOOD
MARGINAL
NO (Explain "No" or "Conditionally" in Remarks.)
14a. NAME, TITLE AND OFFICE OF RATING OFFICIAL
15a. NAME, TITLE AND OFFICE OF REVIEWING OFFICIAL
TELEPHONE NUMBER:
TELEPHONE NUMBER:
c. DATE
(Official
b. SIGNATURE
c. DATE
b. SIGNATURE
Report date)
AGENCY USE: (Distribution, etc.)
DD FORM 2631, APR 1999
PREVIOUS EDITION IS OBSOLETE.
Exception to SF 1421 Approved by GSA/IRMS 11-92.
Reset
WHS/DIOR, Apr 99
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Parent category: Business