Attachment VI - Past Performance Questionnaire (PPQ).doc

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Attached to
USDA-ARS-PWA Install ABC Road/Ramp and Sidewalks Maricopa AZ
Solicitation number
12905B24Q0026
Issued by

About this file

This document contains a past performance questionnaire template and details of a federal contract opportunity for construction services. The past performance questionnaire is to be completed by a contractor's references and submitted to USDA by a given date. The federal contract opportunity is to install an access road, ramp, and sidewalks at a USDA research facility in Maricopa, Arizona. The requirement is for a small business set-aside under NAICS code 237310 with a size standard of $45 million. Offerors must monitor the site for amendments and register with SAM. The site visit is scheduled for a specific date and offers are due by a given date. The contract will be a firm fixed-price award.

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Attachment VI

Request For Proposal (RFQ) # 12905B24Q0026 USDA-ARS-PWA U.S. ALARC Maricopa AZ Attachment III

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

The Contractor shall complete the company specific information on this form, contact their clients, forward this form to their clients and request that their clients complete it (verify/concur and score) and send it via email to theodore.blume@usda.gov

This will expedite the response from each referenced source.

Name of Contractor: ______________________________________________________

Name of client organization:

Project name and contract/task order number:

Brief description of support provided:

Total period of performance, dates, and total cost/price:

Number of contractor personnel assigned to the project, by skill category:

SECTION 1:

Name and Title of Technical Point of Contact (POC):

Address of Technical POC:

Telephone number of Technical POC:

Date the Technical POC was contacted for this PPQ:

Did you inform your client that a past performance questionnaire must be completed and returned to USDA by DATE, and that a USDA representative may contact him/her sometime after that date?

FORMCHECKBOX

Yes FORMCHECKBOX No

Please BOLD the rating your Technical POC indicated he/she would give your project if contacted:

1. Overall Technical Performance

Excellent
Very Good
Good
Fair
Poor
N/A

2.

Quality of work

Excellent
Very Good
Good
Fair
Poor
N/A

3.

Schedule Performance

Excellent
Very Good
Good
Fair
Poor
N/A

4.

Cost Performance

Excellent
Very Good
Good
Fair
Poor
N/A

5.

Did the contractor proactively identify risk areas, mitigate risks, and respond to emergency and critical situations? FORMCHECKBOX Yes FORMCHECKBOX No

6.

Would your Technical POC use your company again? FORMCHECKBOX Yes FORMCHECKBOX No

SECTION 2:

Name and Title of Contracting Point of Contact (POC):

Address of Contracting POC:

Telephone number of Contracting POC:

Date the Contracting POC was contacted for this PPQ:

Did you inform your client that a past performance questionnaire must be completed and returned to USDA by April 28, 2022, and that a USDA representative may contact him/her sometime after that date?

FORMCHECKBOX

Yes FORMCHECKBOX No

Please BOLD the rating your Contracting POC indicated he/she would give your project if contacted:

1.

Overall Contractual Performance

Excellent
Very Good
Good
Fair
Poor
N/A

2.

Would your Contracting POC use your company again? FORMCHECKBOX Yes FORMCHECKBOX No

Employee(s) who made the contact with above-named client references:

File details come from the government source that posted it. Updated .