Sample Only

Contractor Information o General Contractor o Subcontractor

Firm Name

Contact Person

Address

City

State

Zip

Phone

Fax

e-mail

Type of Work o Transportation: o Streets o Lighting o Signals
o Utilities: o Water o Sewer o Storm
o Other (please specify):

List Project Manager and Superintendent and Grade Their Effectiveness:

Project Manager o Excellent o Satisfactory o Marginal o Unsatisfactory
Superintendent o Excellent o Satisfactory o Marginal o Unsatisfactory
Comments:

Progress of Work o Excellent o Satisfactory o Marginal o Unsatisfactory
For example (but not limited to): Was the project completed within the allotted time? How effective were they in scheduling the project and executing that schedule?
Comments:

Quality of Work:

a. Contractor's adherence to plans and specifications: o Excellent o Satisfactory o Marginal o Unsatisfactory
b. Contractor's standards of workmanship:o o Excellent o Satisfactory o Marginal o Unsatisfactory
c. Contractor's completion of punchlist: o Excellent o Satisfactory o Marginal o Unsatisfactory
Comments:

Administration / Supervision / Management:

a. Supervision and decision making: o Excellent o Satisfactory o Marginal o Unsatisfactory
b. Submittal of documents and reports:o o Excellent o Satisfactory o Marginal o Unsatisfactory
c. Coordination and cooperation with City: o Excellent o Satisfactory o Marginal o Unsatisfactory
Comments:

Coordination and Control of Subcontractors:

Coordination and communication with subcontractors o Excellent o Satisfactory o Marginal o Unsatisfactory
and suppliers:o
Comments:

Contract Administration: o Excellent o Satisfactory o Marginal o Unsatisfactory
For example (but not limited to): Did the contractor respond to City correspondence in a timely manner? Were unnecessary cost/price change proposals submitted? Were City-requested price changes submitted and negotiated promptly? Were contract modifications promptly executed? Were the subcontracts properly administered? Did the contractor comply with its subcontracting plan? Were progress reports submitted on time? Were invoices submitted correctly? Were contract discrepancies/problems reported promptly? Were major subcontracts administered properly?
Comments:

Responsiveness to City: o Excellent o Satisfactory o Marginal o Unsatisfactory
For example (but not limited to): Were complaints from the City resolved in a reasonable and cooperative manner? Were telephone calls responded to promptly? Were controversial issues resolved amicably? Was the contractor reasonable and responsive to the City's needs?
Comments:

Safety: o Excellent o Satisfactory o Marginal o Unsatisfactory
Did the contractor provide a safe working environment for his/her employees and the general public?
Comments:

Your Signature

Print Name Date

Title

Phone