SIR Attachment 4 - Past Performance Questionnaire - REVISED 10-20-26 for Amendment 0005.docx
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- Solicitation number
- 697DCK-25-R-00368
About this file
This is a Past Performance Questionnaire (PPQ) form used to evaluate contractor past performance for the FAA's printer consumables procurement (SIR 697DCK-25-R-00368). The form must be completed by references for offerors being considered for the contract and returned to Kay F. Morello (kay.f.morello@faa.gov) and Stephen Young (stephen.young@faa.gov) by the proposal due date. The questionnaire requests information about a contractor's previous work involving 620+ printer consumables across the 48 contiguous United States and District of Columbia, including non-foreign Outside Continental United States (OCONUS) locations, with specific focus on whether delivery timelines of four business days or less were met more than 98% of the time for CONUS/OCONUS orders.
The evaluation section requires references to rate contractors using six-point scale ratings (Exceptional, Very Good, Satisfactory, Marginal, Unacceptable, or Not Applicable) across eight performance dimensions: client relationship, work quality, quality control, schedule performance, schedule problem resolution, cost control, timely documentation submission, and customer satisfaction with deliverables. References must also indicate whether they would award another contract to the firm and provide an overall performance rating. The form includes fields for evaluator name, organization, contact information, and position, with signature and date lines for completion. This revised version (dated October 20, 2026 for Amendment 0005) is part of the IDIQ contract vehicle for toner and printer consumables reserved for small businesses under NAICS 325992 with a five-year period of performance.
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Attachment 4 (SIR # 697DCK-25-R-00368)
PAST PERFORMANCE QUESTIONNAIRE (PPQ)
The Federal Aviation Administration (FAA) AIT (Office of Information Technology) is considering the Offeror listed below for a U.S. Government contract. Your comments would be appreciated regarding this firm’s past performance. After completing this PPQ, return it directly to this office via email to Ms. Kay F. Morello (kay.f.morello@faa.gov and Stephen.young@faa.gov) no later than the Proposal due date and time. Your prompt response is greatly appreciated. If the referenced project is a government project, you may forward a copy of the official performance evaluation in lieu of completing this form.
THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.
Part I – Offeror’s Information (To be completed by Offeror)
Offeror Information
Name of Offeror Being Evaluated:
Address of Offeror Being Evaluated:
CAGE Code of Offeror Being Evaluated:
UEI Number of Offeror Being Evaluated:
Part II- Contract Information (To be completed by Offeror’s Reference) Please provide the following information regarding the contractor identified in Part I above:
Project Information
Contract Number:
Delivery/Task Order Number:
Contract/Project Title:
Location:
Award Date:
Completion Date:
Contract Value:
| Offeror Performed As: |
| |_| Prime Contractor |
Describe how the work performed relates to the purchase of over 620+ printer consumables within the 48 United States, and the District of Columbia, to include non-foreign Outside Continuous United States locations.
| Was the delivery timeline for four (4) -business days or less for CONUS/OCONUS orders? |
| |_| Yes |_| No |
| Did the contractor meet those delivery timelines more than 98% of the time? If not, what percentage? |
| |_| Yes |_| No |
Part III – Ratings and Questions (To be completed by Offeror’s Reference)
Evaluator Information
Name of Evaluator:
Government Agency/Commercial Company:
Address:
Phone Number:
Email Address:
Position Held in Relation to this Project:
Rating: Please evaluate the past performance using only the following ratings without variation.
DO NOT RATE ON A “+” OR “-” SCALE. If a “+” or “-” is used, the rating without the “+” or “-” will be applied. If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.
| “E” |
| Exceptional |
| Performance greatly exceeded the contract requirements. |
| “VG” |
| Very Good |
| Performance exceeded the contract requirements. |
| “S” |
| Satisfactory |
| Performance met the contract requirements. |
| “M” |
| Marginal |
| Performance met the minimum contract requirements, but some material aspects of the contractor’s performance were less than satisfactory. |
| “UA” |
| Unacceptable |
| Performance was poor and/or did not satisfy contract requirements. |
| “NA” |
| Not Acceptable |
| No information or did not apply to your contract |
Please rate and provide any supporting information/comments for the following:
| 1. The relationship between the Offeror and client’s/customer’s contract team: |
| |_| |_| |_| |_| |_| |_| |
E VG S M U NA
| 2. Quality of work: |
| |_| |_| |_| |_| |_| |_| |
E VG S M U NA
| 3. Quality control: |
| |_| |_| |_| |_| |_| |_| |
E VG S M U NA
| 4. Ability to meet the performance schedule: |
| |_| |_| |_| |_| |_| |_| |
E VG S M U NA
| 5. Ability/actions to improve schedule problems, if applicable: |
| |_| |_| |_| |_| |_| |_| |
E VG S M U NA
| 6. Ability to control costs: |
| |_| |_| |_| |_| |_| |_| |
E VG S M U NA
| 7. Ability to submit required documentation (invoices, reports, data, etc.) in a timely manner: |
| |_| |_| |_| |_| |_| |_| |
E VG S M U NA
| 8. Would you award another contract to the party being evaluated? If not, please explain: |
| |_| |_| |
Yes No
| 9. Was the customer satisfied with the end product (deliverables)? If not, please explain: |
| |_| |_| |
Yes No
10. Additional Remarks:
| Overall rating for this firm: |
| |_| |_| |_| |_| |_| |
E VG S M U
Signature of Evaluator Date
RFP/SIR # 697DCK-25-R-00368
Past Performance Questionnaire, Page 1 of 3
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