47QFRA20Q0004 - Attachment 5 - Past Performance Questionnaire.pdf

ID08200023 RFP Attachment 5

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

CONTRACT INFORMATION (Contractor to complete Blocks 1-3)

1. Contractor Information

Firm Name: CAGE Code:

Address: DUNs Number:

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: Firm Fixed Price Cost Reimbursement Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

3. Project Information:

Complexity of Work High Med Routine

Which project submitted for Factor 2 is this PPQ associated with?

CLIENT INFORMATION (Client to complete Blocks 4-7)

4. Client Information

Name:

Title:

Phone Number:

Email Address:

5. Describe the client’s role in the project:

6. Date Questionnaire was completed (mm/dd/yy):

7. Client’s Signature:

NOTE: THE CONTRACTING OFFICER REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS

DIRECTLY BACK TO THE GOVERNMENT AT RACHEL.HICKENLOOPER@GSA.GOV. THE GOVERNMENT RESERVES THE

RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

ID08200023 RFP Attachment 5

TO BE COMPLETED BY CLIENT

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY:

Quality of technical data/report. E VG S M U N

Ability to meet quality standards specified for technical performance. E VG S M U N

Effectiveness of contract problem resolution without extensive customer guidance.

E VG S M U N

Effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance).

E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

Compliance with contract delivery schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below)

E VG S M U N

Rate the contractor’s use of available resources to accomplish tasks identified in the contract.

E VG S M U N

3. CUSTOMER SATISFACTION:

To what extent were the end users satisfied with the project? E VG S M U N

Contractor was reasonable and cooperative in dealing with your staff E VG S M U N

To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer?

E VG S M U N

Overall customer satisfaction. E VG S M U N

4. MANAGEMENT

Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force?

E VG S M U N

Ability to simultaneously manage multiple projects with multiple disciplines. E VG S M U N

Ability to incorporate changes in requirements E VG S M U N

Effectiveness of overall management E VG S M U N

5. SECURITY:

Contractor complied with all security requirements for the project and personnel security requirements.

E VG S M U N

6. GENERAL:

Compliance with contractual terms/provisions (explain if specific issues). E VG S M U N

Please provide a brief narrative addressing the questions above for any rating below Satisfactory. (please attach additional pages if necessary):