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STATE OF NEVADA | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11
DEPARTMENT OF TRANSPORTATION
RESIDENT ENGINEERS' CONFIDENTIAL PAST PERFORMANCE REPORT
CONTRACTORS AND SUBCONTRACTORS
INSTRUCTIONS: |  | Upon completion of a contract this form must be filled out by the Resident Engineer and then forwarded
 |  | directly to the Construction Office. In the event there is a change of Resident Engineers on a contract, the
 |  | Resident Engineer leaving the project must fill out this form and submit it as indicated above.
Check One:
 |  | PRIME CONTRACTOR |  |  | SUBCONTRACTOR |  |  | SPECIALTY CONTRACTOR
Date of Report: |  |  |  |  |  | Acceptance Date:
Contract No.: |  |  |  |  |  | Project No.:
Description:
Contractor:
Address:
Amount of Work: $ |  |  |  | Type of Work:
ANSWER ALL QUESTIONS 1 THROUGH 13 USING THE FOLLOWING PERCENTAGES:
Poor…….0-60% |  |  | Average……….71-80% |  |  |  | Very good or
Fair….....61-70% |  |  | Good……..……81-90% |  |  |  | excellent………91-100%
GROUP 1- COOPERATION
Note:  Each question has a maximum value of 100 percent. Group 1 Rating is the average of total values.
To what degree was the contractor cooperative with:
 | 1. The Department?……………………………………………………………………………….. |  |  |  |  |  |  |  |  |  | %
 | 2. County and Municipal Officials?……………………………………………………………… |  |  |  |  |  |  |  |  |  | %
 | 3. Adjacent property owners, considerate of their rights (ingress & egress, noise & dust)? |  |  |  |  |  |  |  |  |  | %
 | 4. Providing protection for the public?………………………………………………………….. |  |  |  |  |  |  |  |  |  | %
 | 5. Equal employment opportunity requirement?……………………………………………….. |  |  |  |  |  |  |  |  |  | %
 | 6. Safety requirement?…………………………………………………………………………….. |  |  |  |  |  |  |  |  |  | %
 | 7. Others?…………………………………………………………………………………………… |  |  |  |  |  |  |  |  |  | %
 |  | (a) ……………………………………………………………………………………………….. |  |  |  |  |  |  |  |  | %
 |  |  |  |  |  | GROUP 1 RATING    (Maximum 100 %)…. |  |  |  |  | %
GROUP 2 - FURNISHING AND ORGANIZING THE JOB
Note: Each question has a maximum value of 100 percent. Group 2 Rating is the average of total values.
To what degree was the contractor:
 | 8.   Properly supervising the job?………………………………………………………………… |  |  |  |  |  |  |  |  |  | %
 | 9.   Properly manning the job?…………….……………………………………………………… |  |  |  |  |  |  |  |  |  | %
 | 10. Properly equipping the job?………………………………………………………………….. |  |  |  |  |  |  |  |  |  | %
 | 11. Maintaining consistent progress on the job?……………………………………………… |  |  |  |  |  |  |  |  |  | %
 | Organizing the job?……………………………………………………………………………. |  |  |  |  |  |  |  |  |  | %
 | 12. Others?…………………………………………………………………………………………. |  |  |  |  |  |  |  |  |  | %
 | (a)………………………………………………………………………………………………… |  |  |  |  |  |  |  |  |  | %
 |  |  |  |  |  | GROUP 2 RATING    (Maximum 100 %)…. |  |  |  |  | %
GROUP 3 - QUALITY OF WORK
Note:  Each question has a maximum value of 100 percent. Group 3 Rating is the average of total values.
To what degree was the contractor:
 | 13.  Maintaining the quality of work?……………………………………………………………. |  |  |  |  |  |  |  |  |  | %
 |  |  |  |  |  | GROUP 3 RATING     (Maximum 100%)….. |  |  |  |  | %
REMARKS  (Mandatory)
 |  | AVERAGE OF TOTAL VALUES (GROUPS 1, 2, AND 3 MAXIMUM 100 PERCENT) |  |  |  |  |  |  |  |  | %
 |  |  |  |  |  | RESIDENT ENGINEER
 |  |  |  |  | DATE
040-044
REV 8-80