<table style="width:100%;">
<colgroup>
<col style="width: 37%" />
<col style="width: 7%" />
<col style="width: 6%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 5%" />
<col style="width: 5%" />
<col style="width: 7%" />
<col style="width: 2%" />
<col style="width: 8%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="10"><p><strong>SUBCONTRACTOR PERFORMANCE
ASSESSMENT</strong></p>
<p><strong>(Applicable to Subcontracts of $100,000 or
above)</strong></p></td>
</tr>
<tr class="even">
<td colspan="3"><strong>1. NAME/ADDRESS/PHONE NUMBER OF
SUBCONTRACTOR</strong></td>
<td colspan="3"><strong>2. FINAL REPORT</strong></td>
<td colspan="4"><strong>3. DATE OF REPORT</strong></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="7"><strong>3. SUBCONTRACT NUMBER/SUPPLEMENTAL
AGREEMENTS</strong></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="3"><strong>4. DATE OF AWARD</strong></td>
<td colspan="4"><strong>5. SUBCONTRACT VALUE</strong></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="7"><strong>7. SUBCONTRACT COMPLETION DATE</strong></td>
</tr>
<tr class="even">
<td colspan="3"><strong>6. PROJECT TITLE</strong></td>
<td colspan="7"><strong>8. PROCUREMENT ADMINISTRATOR</strong></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="7"><strong>9. CONSTRUCTION COORDINATOR /TASK
MANAGER</strong></td>
</tr>
<tr class="odd">
<td colspan="3"></td>
<td colspan="7"><strong>10. SENIOR SAFETY OFFICER</strong></td>
</tr>
<tr class="even">
<td colspan="3"></td>
<td colspan="3"><strong>11. COMPETITIVE</strong></td>
<td colspan="4"><strong>NONCOMPETITIVE</strong></td>
</tr>
<tr class="odd">
<td colspan="10"><strong>12. SUBCONTRACT TYPE AND LIST OF
SUB-SUBCONTRACTORS</strong></td>
</tr>
<tr class="even">
<td colspan="10"><strong>13. SUBCONTRACT EFFORT DESCRIPTION (HIGHLIGHT
EACH DISCRETE ACTIVITY AND FUNCTION AS APPLICABLE)</strong></td>
</tr>
<tr class="odd">
<td><strong>14. EVALUATE THE FOLLOWING AREAS:</strong></td>
<td><strong>Past Rating</strong></td>
<td><strong>N/A</strong></td>
<td><p><strong>(1)</strong></p>
<p><strong>Unsat</strong></p></td>
<td><p><strong>(2)</strong></p>
<p><strong>Marginal</strong></p></td>
<td colspan="2"><p><strong>(3)</strong></p>
<p><strong>Satisfactory</strong></p></td>
<td colspan="2"><p><strong>(4)</strong></p>
<p><strong>Very Good</strong></p></td>
<td><p><strong>(5)</strong></p>
<p><strong>Exceptional</strong></p></td>
</tr>
<tr class="even">
<td><strong>a. Business Relations</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>b. Management of Key Personnel</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>c. Schedule</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>d. Cost Control</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>e. ES&amp;H (as a minimum the following
factors)</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>(1) Accident and injury report on the job</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(2) Adherence to company safety program</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>(3) Adherence to the HA documents</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(4) Mandatory training completed</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>(5) Training records management</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(6) Compliance with safety standards rules</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>(7) Observation of work activities</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(8) Use of PPE when required</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>f. Performance/Quality of Construction</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(1) Qualified Workers</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>(2) As-built drawings</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(3) Submittals</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>g. Other (specify)</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(1)</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>(2)</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>(3)</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td><strong>(4)</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td><strong>OVERALL EVALUATION</strong></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
</tbody>
</table>

  -------------------- -- ----------------- ----------------------- ----------- ----- ---------- ------ -------- --
  **15a - PERFORMANCE                                                                                            
  EVALUATION/PROGRAM                                                                                             
  TEAM EVALUATION                                                                                                
  NARRATIVE                                                                                                      
  (CONSENSUS)(Attach                                                                                             
  additional documents                                                                                           
  as necessary**                                                                                                 

  **15b - GIVEN WHAT                                                                                             
  WE KNOW TODAY ABOUT                                                                                            
  THE SUBCONTRACTOR\'S                                                                                           
  ABILITY TO EXECUTE                                                                                             
  WHAT WAS IN THE                                                                                                
  SUBCONTRACT:**                                                                                                 

                          **We definitely                                                                        
                          would not                                                                              
                          recommend a                                                                            
                          future award -**                                                                       

                                                                                                                 

                          **We probably                                                                          
                          would not                                                                              
                          recommend a                                                                            
                          future award -**                                                                       

                                                                                                                 

                          **We might or                                                                          
                          might not                                                                              
                          recommend a                                                                            
                          future award -**                                                                       

                                                                                                                 

                          **We probably                                                                          
                          would recommend a                                                                      
                          future award -**                                                                       

                                                                                                                 

                          **We definitely                                                                        
                          would recommend a                                                                      
                          future award -**                                                                       

                                                                                                                 

                                                                                                                 

  **16. NAME OF                                                     **MAIL            **PHONE                    
  PROCUREMENT                                                       STATION**         NUMBER**                   
  ADMINISTRATOR TEAM                                                                                             
  HEAD**                                                                                                         

  **SIGNATURE**                                                                       **DATE**                   

  **17a. REVIEW BY                                                                                               
  REVIEWING OFFICIAL**                                                                                           

                                                                                                                 

                          **Concur**                                                                             

                                                                                                                 

                          **Do not concur**                                                                      

                                                                                                                 

  **17b. REVIEWING                                                                                               
  OFFICIAL\'S                                                                                                    
  COMMENTS:**                                                                                                    

  **18. NAME OF REVIEW                                              **MAIL            **PHONE                    
  OFFICIAL**                                                        STATION**         NUMBER**                   

  **SIGNATURE**                                                                       **DATE**                   

  **INSTRUCTIONS FOR                                                                                             
  COMPLETING FORM**                                                                                              

                                                                                                                 

  **ITEM**                                  **DESCRIPTION**                                                      

                                                                                                                 

  **1 through 13**                          **To be completed by                                                 
                                            the Procurement                                                      
                                            Administrator within 30                                              
                                            days after                                                           
                                            subcontractor                                                        
                                            completion**                                                         

                                                                                                                 

  **14**                                    **To be completed by                                                 
                                            the Evaluation/Program                                               
                                            Team**                                                               

                                                                                                                 

  **14.a**                                  **BUSINESS RELATIONS                                                 
                                            \-- Assess the                                                       
                                            integration and                                                      
                                            coordination of all                                                  
                                            activity needed to                                                   
                                            execute the                                                          
                                            subcontract,                                                         
                                            specifically the                                                     
                                            timeliness,                                                          
                                            completeness and                                                     
                                            quality of problem                                                   
                                            identification,                                                      
                                            corrective action                                                    
                                            plans, proposal                                                      
                                            submittals, the                                                      
                                            subcontractor\'s                                                     
                                            history of reasonable                                                
                                            and cooperative                                                      
                                            behavior, customer                                                   
                                            satisfaction, timely                                                 
                                            award and management of                                              
                                            sub-subcontracts, and                                                
                                            whether the                                                          
                                            subcontractor met                                                    
                                            small/small                                                          
                                            disadvantaged and                                                    
                                            women-owned business                                                 
                                            participation goals.**                                               

                                                                                                                 

  **14.b**                                  **MANAGEMENT OF KEY                                                  
                                            PERSONNEL \-- Assess                                                 
                                            the subcontractor\'s                                                 
                                            performance in                                                       
                                            selecting, retaining,                                                
                                            supporting, and                                                      
                                            replacing, when                                                      
                                            necessary, key                                                       
                                            personnel**                                                          

                                                                                                                 

  **14.c**                                  **SCHEDULE \-- Assess                                                
                                            the timeliness of the                                                
                                            subcontractor against                                                
                                            the completion of the                                                
                                            subcontract, task                                                    
                                            orders, milestones,                                                  
                                            delivery schedules,                                                  
                                            administrative                                                       
                                            requirements, (e.g.                                                  
                                            efforts that contribute                                              
                                            to or effect the                                                     
                                            schedule variance).**                                                

                                                                                                                 

  **14.d**                                  **COST CONTROL \--                                                   
                                            Assess the                                                           
                                            subcontractor\'s                                                     
                                            effectiveness in                                                     
                                            forecasting, managing,                                               
                                            and controlling                                                      
                                            subcontractor costs.**                                               

                                                                                                                 

  **14.e**                                  **ES&H \-- Assess the                                                
                                            subcontractor\'s                                                     
                                            compliance with the                                                  
                                            overall safety concerns                                              
                                            related to the                                                       
                                            subcontract (e.g.                                                    
                                            environmental, safety                                                
                                            and health standards.**                                              

                                                                                                                 

  **14.f**                                  **PERFORMANCE/QUALITY                                                
                                            OF CONSTRUCTION \--                                                  
                                            Assess the                                                           
                                            subcontractor\'s                                                     
                                            conformance to contract                                              
                                            requirements,                                                        
                                            specifications and                                                   
                                            standards of good (e.g.                                              
                                            commonly accepted                                                    
                                            technical and                                                        
                                            professional                                                         
                                            standards).**                                                        

                                                                                                                 

  **14.g**                                  **OTHER \-- List any                                                 
                                            other factor that may                                                
                                            be relative to this the                                              
                                            subcontractor.**                                                     

                                                                                                                 

  **OVERALL                                 **Enter the overall                                                  
  EVALUATION**                              evaluation for this                                                  
                                            subcontractor                                                        
                                            performance**                                                        

                                                                                                                 

  **15**                                    **To be completed by                                                 
                                            the evaluation/program                                               
                                            team**                                                               

                                                                                                                 

  **16**                                    **Signature of the                                                   
                                            Chair                                                                
                                            Evaluation/Program                                                   
                                            team**                                                               

                                                                                                                 

  **17**                                    **To be completed by                                                 
                                            the Reviewing/Approving                                              
                                            Official**                                                           

                                                                                                                 

  **18**                                    **Signature of the                                                   
                                            Reviewing/Approving                                                  
                                            Official**                                                           
  -------------------- -- ----------------- ----------------------- ----------- ----- ---------- ------ -------- --

+-----------------------------------------------------------------------+
| **ASSESSMENT RATING SYSTEM**                                          |
+-----------------------------------------------------------------------+
| **[Exceptional.]{.underline}**                                        |
|                                                                       |
| **Performance meets the contractual requirements and exceeds many to  |
| Fermilab\'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 subcontractor were highly   |
| effective.**                                                          |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+
| **[Very Good.]{.underline}**                                          |
|                                                                       |
| **Performance meets contractual requirements and exceeds some to      |
| Fermilab\'s benefit. The contractual performance of the element or    |
| sub-element being assessed was accomplished with some minor problems  |
| which corrective actions taken by the subcontract were effective.**   |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+
| **[Satisfactory]{.underline}.**                                       |
|                                                                       |
| **Performance meets contractual requirements. The contractual         |
| performance of the element or sub-element contains some minor         |
| problems for which corrective actions taken by the subcontractor      |
| appear or were satisfactory.**                                        |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+
| **[Marginal.]{.underline}**                                           |
|                                                                       |
| **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 subcontractor has not yet    |
| identified corrective actions. The subcontractor\'s proposed actions  |
| appear only marginally effective or were not fully implemented.**     |
+-----------------------------------------------------------------------+
|                                                                       |
+-----------------------------------------------------------------------+
| **[Unsatisfactory]{.underline}.**                                     |
|                                                                       |
| **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 subcontractor\'s corrective actions appear or were      |
| ineffective.**                                                        |
+-----------------------------------------------------------------------+

Distribution: Contract Administrator, Requisitioner, File

ESH Admin Form #15 12/2001