Attachment 4 Past Performance Questionnaire (PPQ).pdf

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

A. Your Company Name and Address:

B. Phone /Fax #:

C. Point of Contact/Email Address:

D. Authorization is hereby granted to provide the information requested in SECTION II and III of this questionnaire.

Signature of Authorized Contractor Representative Date

Printed Name and Title of Authorized Contractor Representative

SECTION II: RESPONDENT INFORMATION: Request a reference from respondent by completing Section II and III and return to:

A. Client/Reference Name and Address:

B. Phone /Fax #:

C. Point of Contact/Email Address:

D. Reference Contract Number:

Project Title:

Contract Value/Type:

Period of Performance:

How long have you worked with the contractor:

More detailed description of the work performed:

Date completed:

Past Performance Evaluation Ratings Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation. Alternatively, select N/A where appropriate.

Rating Description

1 = Unsatisfactory Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective

2 = Marginal Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective.

3 = Satisfactory Performance met contractual requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory.

4 = Very Good Performance met all contract requirements and exceeded some to the government’s benefit. There were a few minor problems, which the contractor resolved in a timely, effective manner.

5 = Exceptional Performance met all contract requirements and exceeded many to the government’s benefit. Problems, if any, were negligible and were resolved in a timely, highly effective manner.

N/A = Neutral or N/A No record of past performance, the record is inconclusive, or rated area is not applicable

SECTION I: CONTRACTOR INFORMATION

SECTION III: PERFORMANCE EVALUATION

1 Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

1 2 3 4 5 N/A

2 Home office participated in solving significant local problems. 1 2 3 4 5 N/A

3 Provided effective quality control and/or inspection procedures to meet contract requirements. 1 2 3 4 5 N/A

4 Corrected deficiencies in timely manner and pursuant to their quality control procedures. 1 2 3 4 5 N/A

5 Identified problems as they occurred. 1 2 3 4 5 N/A

6 Suggested alternative approaches to problems. 1 2 3 4 5 N/A

7 Displayed initiative to solve problems. 1 2 3 4 5 N/A

8 Cooperated with Government personnel after award. 1 2 3 4 5 N/A

9 How would you rate the contractor's overall performance? 1 2 3 4 5 N/A

10 Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “remarks.”

YES/NO/

Unknown

11 Would you award another contract to this contractor? If not, explain in “remarks.” YES/NO

REMARKS: Please provide a narrative explanation for any ratings of 1 or 2.