Free 19896.FH11 - Indiana

REPORT ON CONTRACTORS PERFORMANCE
State Form 19896 (R7 / 1-07) / CR-2 DEPARTMENT OF TRANSPORTATION Name of contractor District Project location / description Name of contractor person in charge at site This contractor is: This report is: Work performed

Reset Form

Contract number Contract amount

Date report completed (month, day, year)

Prime contractor

Sub-contractor

Interim

Year-end

Final

GRADING SCALE Unless a different point system is shown for a question, use only the following scale to grade performance of the contractor on each question. Do not use any numbers not shown. +2 For outstanding performance throughout the project that strongly contributed to the success of the project +1 For performance above expectations throughout the project 0 For adequate performance meeting expectations -1 For periodic inadequate performance, causing occasional problems that adversely affected the project -3 For consistently inadequate performance, causing constant problems adversely impacting the project NA If there were insufficient opportunities to observe contractor performance in this area SECTION A - ORGANIZATION EQUIPMENT AND PERSONNEL 1. Contractor management personnel were knowledgeable and available with full authority to execute contract documents and implement the directions of the engineer. 2. The project was staffed and managed with competent (non-supervisory) employees. 3. Contractor management personnel effectively anticipated upcoming issues and effectively scheduled and organized construction operations, including subcontractors. 4. The superintendent or foremen on the jobsite had the required knowledge and training to comply with the plans, special provisions, and specifications on the project. 5. The contractor complied with applicable wage rates and employment regulations and timely submitted accurate certified payrolls. 6. The contractor complied with EEO and DBE requirements and procedures. 7. The contractor ensured that subcontractors were knowledgeable and capable to perform the subcontracted work. 8. The contractor provided safe, adequate, and well-maintained equipment to perform the required work. SECTION A - TOTAL POINTS SECTION B - PROSECUTION OF WORK 1. The contractor furnished the required documentation and reports in a timely manner (i.e. certification of materials, delivery tickets, invoices, progress schedules, shop drawings, material sampling, early notice of time extension, potential claims, etc.) 2. The contractor informed the PE / PS in advance of the daily schedule. 3. The contractor submitted, followed, and kept the work schedule up-to-date and met intermediate and final completion dates. 4. The contractor complied with the phasing requirements. 5. The contractor complied with the direction of INDOT personnel. 6. The project site was maintained in a safe condition and the work conducted in a safe manner. 7. Traffic control was maintained as specified in the traffic plan for the safety of the public and project. 8. The contractor followed contract requirements for maintaining erosion control, disposal of materials, borrow sites, and other environmental matters. SECTION B - TOTAL POINTS SECTION C - GENERAL RELATIONSHIPS / COOPERATION 1. The contractors supervisory personnel demonstrated a positive attitude toward the PE / PS and department regulations, including the INDOT chain of command. 2. The contractor properly notified and coordinated work with utility companies for the protection of existing utilities. 3. The contractor planned, scheduled, and coordinated the work with subcontractors. 4. The contractor coordinated with other contractors performing work on adjacent projects. 5. Contract issues and disputes were settled at the appropriate level. 6. The contractor responded to contract issues and disputes in a timely manner. 7. The contractor showed consideration to the traveling public. 8. The contractor communicated and cooperated with the adjacent property owners and local agencies. SECTION C - TOTAL POINTS POINTS

0
POINTS

0
POINTS

0

SECTION D - QUALITY OF MATERIALS AND WORKMANSHIP 1. The contractor provided an adequate and fully equipped field office throughout the project. 2. The contractor assured consistent quality of work performed, eliminating the need to remedy or remove defective work. 3. The contractor completed the punch list and final cleanup as directed by the PE / PS. 4. The contractor managed the work to maximize the quality of work and use of good construction practices. 5. The contractor met the smoothness requirements of the contract. 6. The prime contractor exercised authority and monitored the subcontractors activities to ensure approved materials and quality work. 7. The contractor ensured that an overall safe project was conducted. 8. The overall project was of high quality and conformed to the contractual requirements. SECTION D - TOTAL POINTS

POINTS

0

Section A B C D TOTAL

CONTRACTOR SCORE Points Received A total score below zero in any Section or a score of -3 on any 0 question may be cause for immediate referral to the Prequalification 0 Committee. The total scores will be used in the overall contractor 0 evaluation process. 0

0

GENERAL REMARKS (Attach additional sheets, if necessary.)

Name of PE / PS Name of Area Engineer (concur)

Signature of PE / PS Signature of Area Engineer

Date (month, day, year) Date (month, day, year)

The contractors superintendent acknowledges receipt of this form and that an opportunity was provided to discuss the ratings.
Name of contractors superintendent Signature of contractors superintendent Date (month, day, year)

Date of final inspection (month, day, year)