20Q1047 Atch 7 PPQ.docx

For Official Use Only When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

Attachment 7: Past Performance Questionnaire Section 1: Contract Identification

A. Contractor (Company/Division): Click or tap here to enter text.

B. Contractor Cage Code: Click or tap here to enter text.

C. Contract Number: Click or tap here to enter text.

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.): Click or tap here to enter text.

E. Contract Title: Click or tap here to enter text.

F. Brief Contract Description: Click or tap here to enter text.

G. Period of Performance

1. Original Schedule (assuming all options exercised):

Beginning Date _________ through ____________

2. Current Schedule (assuming all options exercised):

Beginning Date _________ through ____________

3. Reason for difference (if applicable): Click or tap here to enter text.

H. Contract Dollar Value

1. Original maximum contract dollar value (assuming all options exercised): $Click or tap here to enter text.

2. Current maximum contract dollar value (assuming all options exercised): $Click or tap here to enter text.

3. Reasons for difference between original and current contract dollar value (if applicable): Click or tap here to enter text.

I. Description of work performed: Click or tap here to enter text.

J. Was this a competitively awarded contract? ☐ Yes ☐ No

K. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Key Personnel

Note: If offeror holds or has held other contracts with your agency/organization in the last five (5) years, please complete separate Past Performance Questionnaire forms for those contracts as well.

Section 2: Customer or Agency Identification

A. Customer or agency name: Click or tap here to enter text.

B. Customer or agency description (if applicable): Click or tap here to enter text.

C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide, other Commands): Click or tap here to enter text.

Section 3: Respondent Identification

A. Respondent’s name: Click or tap here to enter text.

B. Respondent’s title: Click or tap here to enter text.

C. Respondent’s phone/fax number/e-mail address: Click or tap here to enter text.

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role: Click or tap here to enter text.

E. Other suggested points of contact: Click or tap here to enter text.

Section 4: Performance Information

In the table below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting information for each response in the space provided. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements to the Government’s benefit. The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements to the Government’s benefit. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

M MARGINAL – Performance does not meet some contractual requirements. The contractual performance being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

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

SUPPORTING INFORMATION:

2. Demonstrated the ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems.

5. Provided effective quality control and/or inspection procedures to meet contract requirements.

6. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

7. Provided timely resolution of contract discrepancies.

8. Identified problems as they occurred.

9. Met established performance schedules.

10. Was responsive to contract changes.

11. Provided adequate contract supervision.

12. Cooperated with Government personnel after award.

13. How would you rate the contractor's overall performance on this contract?

14. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain.

EXPLANATION:

☐ Yes ☐ No

15. Would you award another contract to this contractor? If not, explain.

EXPLANATION:

☐ Yes ☐ No

IF THIS WAS A GOVERNMENT CONTRACT:

Did this contract include FAR 52.219-8, Utilization of Small Business Concerns?

☐ Yes ☐ No

If yes, did the contractor comply with the clause? Please explain.

Additional remarks:

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

E-Mail: 509cons.sollgca@us.af.mil Attention: SSgt Tordonato For Official Use Only Page 5 of 5