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FOR OFFICIAL USE ONLY(When Completed)

PERFORMANCE EVALUATION - PROFESSIONAL SERVICES (A/E) CONTRACTS

1. CONTRACTOR (Name, Address and ZIP code) 2. CONTRACT NUMBER:

3. PROJECT TITLE:

4. PROJECT NUMBER:

5. BASE CONTRACT AMOUNT 6. CONTRACT MODIFICATION(S) 7. AMENDED CONTRACT AMOUNT

$ $ $8. STAGE 3 - FINAL PLANS/SPECS DUE DATE 9. REVISED STAGE 3 COMPLETION DATE 10. CONTRACT COMPLETION DATE

11. SUMMARY OF EVALUATION [Check ( ) applicable box] 12. EVALUATING ORGANIZATION [Check (√) applicable box]

a. OUTSTANDING (O) a. UHM - FACILITIES PLANNING AND MANAGEMENT OFFICE

b. SATISFACTORY (S) b. CC - PHYSICAL FACIL., PLANNING & CONSTRUCTION OFFICE

c. UNSATISFACTORY (U) c. UHH - FACILITIES, PLANNING AND CONSTRUCTION OFFICE

d. SYS - OFFICE OF CAPITAL IMPROVEMENTS

e. _________________________________________ (other unit)

13. ATTRIBUTES (PLANNING / DESIGN PHASE) (O) (S) (U) 14. ATTRIBUTES (CONSTRUCTION PHASE) (O) (S) (U)[Check (√) applicable box] [Check (√) applicable box]

Site Investigation Due Diligence Design Constructability

Quality Control Procedures and Execution Cooperativeness and Responsiveness

Plans/Specs Accurate and Coordinated Timeliness and Quality of Processing Submittals

Completing Tasks and Project On-Schedule Timeliness of Answers to RFIs

Environmental Issues Addressed Field Consultation and Investigation

Cooperativeness and Responsiveness

Quality of Briefing and Presentations

15. EVALUATOR (Project Coordinator)

a. NAME AND TITLE (Type or print) b. SIGNATURE c. DATE

16. EVALUATION REVIEWED BY

a. NAME AND TITLE (Type or print) b. SIGNATURE c. DATE

FOR OFFICIAL USE ONLY(When Completed)

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Form OCI-001

FOR OFFICIAL USE ONLY (When Completed)

17. REMARKS ON 'OUTSTANDING' PERFORMANCE - AS INDICATED BY THE CONTRACTOR'S PERFROMANCE ON THIS CONTRACT. IF YOUCONSIDER THE CONTRACTOR TO BE 'OUTSTANDING', SET FORTH FACTUAL DATA IN SUFFICIENT DETAIL SUPPORTING THIS OBSERVATION.(Continue on separate sheet, if needed.)

18. EXPLANATION OF 'UNSATISFACTORY' EVALUATION. PROVIDE FACTS CONCERNING SPECIFIC EVENTS OR ACTIONS TO JUSTIFY THEEVALUATION. (Continue on separate sheet, if needed.)

19. EVALUATION RATING CRITERIA:

"OUTSTANDING" - Performance meets contractual requirements and exceeds many to the benefit of the University.The contractual performance of the attribute being assessed was accomplished with few minorproblems for which corrective action(s) taken by the Contractor were highly effective.

"SATISFACTORY" - Performance meets contractual requirements. The contractual performance of the attribute beingassessed contains some minor problems for which corrective actions taken by the Contractorwere satisfactory.

"UNSATISFACTORY" - Performance does not meet some or most contractual requirements and recovery is not likely in atimely manner. The contractual performance of the attribute being assessed contains seriousproblems for which the Contractor's corrective actions were not fully implemented or wereineffective.

FOR OFFICIAL USE ONLY (When Completed)

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Form OCI-001