Past_Performance_Evaluation_Questionnaire.docx

Past Performance Evaluation Questionnaire (PPQ) Time Sensitive: Please respond no later than August 4, 2014

Instructions for Past Performance Reference: This would have sent to you directly from a prospective Respondent for this solicitation.

1. You have been designated as the point of contact for information relative to the past performance history/experience of a respondent competing for Architect-Engineer Services relative to Sanitation Facilities Construction requirements – Indefinite Delivery Indefinite Quantity Contracts, where the awarded firms will be eligible to compete for task orders covering a broad range of design and engineering projects. The work will be on individual homes and communities on Indian Reservations and IHS medical facilities in elected Contract Areas in Arizona, California; southern Colorado, Nevada, New Mexico and southeastern Utah.

2. This PPQ document is in MS Word to facilitate ease of filling in. We would appreciate you converting this to PDF prior to emailing to the Contracting Officer of this project. Please complete the attached Past Performance Questionnaire from Section 2 on and return it to the Indian Health Service – Division of Engineering Services (IHS-DES) Contracting Officer at the e-mail address shown at the bottom of this page.

3. It is very important that you complete and return this Questionnaire at your very first opportunity. Please make every effort to be thorough in your answers/comments.

4. The information you provide is necessary and is considered an important component of the evaluation process. The information contained herein shall be treated as source selection sensitive and will not be provided to the Respondents of this solicitation or awarded contractor(s).

5. You may be contacted by the IHS-DES technical personnel during the course of the evaluation process for further information. In the event you are a Federal Agency and you have performance evaluation records generated under FAR 42.15, please forward these records to me concurrent with the return of this Questionnaire.

6. If you have any additional questions please contact me as shown below.

With appreciation for your time and attention, Dan Finley Contract Specialist

IHS-DES

1301 Young Street, Suite 1071 Dallas, Texas 75202-5433

PH: 214-767-5255

Email: dan.finley@ihs.gov

Attachment 1

SOURCE SELECTION SENSITIVE INFORMATION

Past Performance Evaluation Questionnaire (PPQ)

Attachment 1

SOURCE SELECTION SENSITIVE INFORMATION

Section 1 to be completed by the firm sending PPQ to the past performance reference.

SECTION 1: RESPONDENT INFORMATION

A. Respondent’s name and address:

B. Point of Contact: C. Phone Number (with area code):

D. Contract Number or ID:

E. Project Title or Description of Work performed under this contract:

Other

J. Authorization is hereby granted to provide the information requested in SECTION B of this Questionnaire.

(Signature)

(Name and Title of Authorizing Official) (Date)

SECTION 2: EVALUATOR INFORMATION (to be completed by the reference or client/customer of contractor/respondent) EVALUATED BY Firm Name & Address

(Signature) (Date)

(Typed or Printed Name)

(Title)

Phone Number:_____________________

Number of months evaluator worked on contract being evaluated:

Section 3 – Performance Sub-factors

Unsatisfactory Marginal Satisfactory Good Outstanding x n

Circle the number on the scale of 1 to 5 that most accurately describes the contractor’s performance in the tabled performance factors.

Past Performance sub-factors

b. Contractor was reasonable and cooperated to resolve problems, attended meetings as needed and maintained communication with the government/ client to keep the project on schedule or minimize the delay.

c. Contractor identified problems as the occurred; suggested approaches to the problems; displayed initiative to solve problems; and performed as a team member.

Performance Factors Continued next page

Past Performance Factors and sub-factors (cont)

a. Contractor provided experienced/qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements and safety regulations.

c. Contractor identified problems as they occurred; suggested approaches to the problems; displayed initiative to solve problems; and performed as a team member.

d. Contractor ensured the project manager had sufficient authority to make decisions and take actions during project performance to keep the project on schedule.

e. Contractor ensured site superintendent and quality control representative were consistently present on site when work was performed.

b. Contractor demonstrated the ability to control costs and/or design projects or modifications within the magnitude specified.

REMARKS: utilize next and last blank page and reference performance area for augmenting remarks and particularly for ratings of Unsatisfactory or Marginal.

NOTE: Please list in the remarks other contracts/projects this contractor has completed for your firm or agency.

Section 4 NARRATIVE SUMMARY: You are encouraged to expand your comments using MS Word to elaborate.

1. What were the contractor’s greatest strengths in the performance of the contract?

2. What were the contractor’s greatest weaknesses in the performance of the contract?

3. Please provide any additional comment concerning the contractor’s performance on the last, blank page.

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules, etc.)

Was the contractor ever issued a notice to correct deficiencies to avoid termination action under the referenced contract? If yes, explain outcome in Remarks last page. Circle answer No / Yes

Thank you for your prompt response and assistance!

DUE DATE NOTE: The firm that sent you this is responsible for following up and keeping you informed of any changes to the due date for getting this PPQ to the Indian Health Service.

Please return this completed questionnaire not later than the date/time specified in the RFP.

Dan Finley – Contract Specialist IHS Division of Engineering Services 1301 Young Street Suite 1071 Dallas, Texas 75202 dan.finley@ihs.gov Please type ‘PPQ-SFC A-E Services’ in email subject line.