Appendix 2 PPQ.pdf

Source Selection Information see FAR 3.104 Appendix 2

Past Performance Questionnaire

PAST PERFORMANCE QUESTIONNAIRE

You have been named as a point of contact for services previously provided by the contractor cited herein.

Please provide the information requested in the questionnaire. The information you provide will become part of the source selection documentation, however your name will not be released to any of the parties.

Should you have any questions concerning this request, please contact Sebastiano Paciello at E-mail sebastiano.paciello.ln@us.navy.mil or Ricardo Alberto Lopez at E-mail at ricardo.a.lopez38.civ@us.navy.mil .

(To be completed by NAVSUP FLC)

Contractor:

Address:

(To be completed by person to whom questionnaire is addressed):

1. Background Information

a. Name of person completing this questionnaire and position.

Name: _______________________________________ Tel No. _______________________________________ E-mail Address: _______________________________________ E-mail Address: _______________________________________

b. Contract No: ___________________________

c. Description of service: ___________________________________________________________

d. Period of Performance (all years): ____________________________________

e. Total value of the contract (all years): __________________________________ mailto:sebastiano.paciello.ln@us.navy.mil mailto:ricardo.a.lopez38.civ@us.navy.mil mailto:david.a.biggs20.civ@us.navy.mil mailto:david.a.biggs20.civ@us.navy.mil

Past Performance Questionnaire

2. Contractor's Past Performance

a. In your opinion, is the work performed under your contract is similar in scope, size and complexity as the work described below:

NAVSUP FLC Sigonella, Detachment Naples is currently evaluating competitive offers for vector-borne infection surveillance ain Ghana. The Contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, consumables, and non-personal services necessary to conduct surveillance for vector-borne infections within the Ashanti Region of southern Ghana, as outlined in this Performance Work Statement (PWS). The Contractor may receive government-furnished property and services as specified. The Contractor shall perform all tasks in accordance with the standards set forth in this contract. Contractors shall be knowledgeable of GHANAIAN partners that live in Ghana and are headquartered there. Contractors shall have laboratory capabilities in Kumasi where vector speciation and molecular analysis can be done on site.

Please circle one of the four levels of relevancy:

RATING

VR R SR NR Scope VR R SR NR Magnitude VR R SR NR Complexity

VR= Very Relevant R = Relevant SR= Somewhat Relevant NR= Not Relevant

Scope: Range of operations covered Magnitude: Dollar value

Complexity: Degree of difficulty

Comments: _______________________________________________________________________

The definitions for relevancy ratings are as follows:

Very Relevant: Present/past performance effort involved essentially the same scope, magnitude of efforts, and complexities this solicitation requires.

Relevant: Present/past performance effort involved similar scope, magnitude of efforts, and complexities this solicitation requires.

Somewhat Relevant: Present/past performance effort involved some of the scope, magnitude of efforts, and complexities this solicitation requires.

Not Relevant: Present/past performance effort involved little or none of the scope, magnitude of efforts, and complexities this solicitation requires.

b. Please circle a rating in answer to each of the following questions and provide comments as appropriate.

1. How would you rate the quality of services received?

Past Performance Questionnaire

Substantial Satisfactory Limited No Confidence Unknown Confidence Confidence Confidence Confidence

Comments: ________________________________________________________________

The definitions for confidence ratings are as follows:

Substantial Confidence Based on the offeror’s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort.

Satisfactory Confidence Based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.

Limited Confidence Based on the offeror’s recent/relevant performance record, the Government has a low expectation that the offeror will successfully perform the required effort.

No Confidence Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.

Unknown Confidence No recent/relevant performance record is available or the offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.

2. How would you rate the timeliness of the services received?

Substantial Satisfactory Limited No Confidence Unknown Confidence Confidence Confidence Confidence

Comments: ________________________________________________________________

3. How would you rate customer satisfaction?

Substantial Satisfactory Limited No Confidence Unknown Confidence Confidence Confidence Confidence

Comments: ________________________________________________________________

4. To what extent did the contractor’s performance conform to the terms and conditions of the contract/employment?

Substantial Satisfactory Limited No Confidence Unknown Confidence Confidence Confidence Confidence

Comments: ________________________________________________________________

Past Performance Questionnaire

5. To what extent was the contractor reasonable and cooperative during performance

(including cooperating with successor contractor)?

Substantial Satisfactory Limited No Confidence Unknown Confidence Confidence Confidence Confidence

Comments: _______________________________________________________________

c. Other comments: ________________________________________________________________

PAST PERFORMANCE QUESTIONNAIRE (Cont’d)

OVERALL RATING

□ SUBSTANTIAL CONFIDENCE: Based on the offeror’s recent/relevant performance record, the Government has a high expectation that the offeror will successfully perform the required effort.

□ SATISFACTORY CONFIDENCE: Based on the offeror’s recent/relevant performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort.

□ LIMITED CONFIDENCE: Based on the offeror’s recent/relevant performance record, the Government has a low expectation that the offeror will successfully perform the required effort.

□ NO CONFIDENCE: No Confidence Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort.

□ UNKNOWN CONFIDENCE: No recent/relevant performance record is available or the offeror’s performance record is so sparse that no meaningful confidence assessment rating can be reasonably assigned.