Att.4_Past Performance Questionnaire.pdf

- SOURCE SELECTION SENSITIVE -

CONTROLLED UNCLASSIFIED INFORMATION

FORM PPEP C

PAST PERFORMANCE QUESTIONNAIRE

Questionnaires for subcontractors cannot be submitted for work done for the prime contractor.

PAST PERFORMANCE PROJECT INFORMATION (To be filled out by the Offeror):

CONTRACTOR NAME:

CONTRACT NUMBER:

ORDER NUMBER (if applicable):

PROJECT TITLE:

TOTAL PERIOD OF PERFORMANCE,

INCLUDING OPTIONS : MM/YYYY –

MM/YYYY OR Present

TOTAL CONTRACT VALUE:

CONTRACT TYPE:

DESCRIPTION OF WORK

PERFORMED:

PAST PERFORMANCE REFERENCE INFORMATION (To be filled out by the Rater/Customer):

NAME:

TITLE:

AGENCY OR CUSTOMER:

PHONE:

E-MAIL:

SIGNATURE OF RATER: (Rater must be provided by a Contracting Officer, Contracting Officer Representative or Corporate Officer with cognizance over the project for the ordering activity.

For each of the six (6) criteria listed below, the rater must choose one (1) Adjectival Rating by checking the box, as applicable. At a minimum, for any rating that is checked as equivalent to unsatisfactory, please submit additional comments to substantiate the rating.

For any rating that would be Not Applicable, please explain why it does not apply.

Evaluation Plan Overview

SIR 6973GH-22-R-00006

NOTE TO RATER/CUSTOMER:

DO NOT return this questionnaire to the Offeror. Please submit only to the Contracting officer via email: helaina.k.germosen@faa.gov.

FORM PPEP C

PAST PERFORMANCE QUESTIONNAIRE

1. Quality/Timeliness of Service.

a. How would you rate the contractor's general overall compliance with contract requirements?

Considerably surpassed minimum requirements ( ) Exceeded minimum requirements ( ) Met minimum requirements ( ) Less than minimum requirements ( ) Not Applicable ( )

b. How would you rate the timeliness of the Contractor's service - delivered reports on time and adhering to the required schedule?

Considerably surpassed minimum requirements ( ) Exceeded minimum requirements ( ) Met minimum requirements ( ) Less than minimum requirements ( ) Not Applicable ( )

c. Did the contractor commit adequate resources in timely fashion to meet contract requirements?

Provided abundant resources ( ) Provided sufficient resources ( ) Provided minimal resources ( ) Provided insufficient resources ( ) Not Applicable ( )

d. Did the contractor commit adequate resources in timely fashion to solve problems?

Provided abundant resources ( ) Provided sufficient resources ( ) Provided minimal resources ( ) Provided insufficient resources ( ) Not Applicable ( )

e. How would you rate the contractor on the timeliness of its responses to inquiries or other administrative matters?

Extremely timely ( ) Generally timely ( ) Generally not timely ( ) Seldom timely ( ) Not applicable ( )

ADDITIONAL COMMENTS:

CONTROLLED UNCLASSIFIED INFORMATION

Evaluation Plan Overview

SIR 6973GH-22-R-00006

FORM PPEP C

PAST PERFORMANCE QUESTIONNAIRE

2. Cost Control.

a. If applicable, to what extent did the contractor meet the proposed cost estimates?

Less than estimated cost ( ) Comparatively equal to estimate ( ) Exceeded the costs ( ) Considerably surpassed estimate ( ) Not applicable ( )

b. How would you rate the contractor's initiative, if any, in reducing overall costs to the Government?

Extremely efficient ( ) Generally efficient ( ) Generally inefficient ( ) Extremely inefficient ( ) Not applicable ( )

ADDITIONAL COMMENTS:

CONTROLLED UNCLASSIFIED INFORMATION

FORM PPEP C

PAST PERFORMANCE QUESTIONNAIRE

3. Business Relations - Effective Management.

a. To what extent was the contractor able to solve contract performance problems without extensive guidance from government (or entity with requirement) counterparts?

Considerably successful ( ) Generally successful ( ) Little Success ( ) No success ( ) Not applicable ( )

b. To what extent did the contractor display initiative in meeting contract requirements?

Displayed considerable initiative ( ) Displayed some initiative ( ) Displayed little initiative ( ) Displayed no initiative ( ) Not applicable ( )

c. Was the contractor's selection and use of personnel appropriate for the performance of this contract?

Provided highly qualified personnel ( ) Provided qualified personnel ( ) Provided minimal personnel ( ) Provided insufficient personnel ( ) Not applicable ( )

d. To what extent was the contractor effective in interfacing with the Government's (or other) staff?

Extremely effective ( ) Generally effective ( ) Generally ineffective ( ) Extremely ineffective ( ) Not applicable ( )

e. Has this contract been partially or completely terminated for default, or is a termination pending?

( ) Yes ( ) No

f. Has it ever been necessary to send this Contractor a Notice to Cure letter?

( ) Yes ( ) No

CONTROLLED UNCLASSIFIED INFORMATION

FORM PPEP C

PAST PERFORMANCE QUESTIONNAIRE

g. How would you rate the performance of the contractor's key personnel?

Extremely effective ( ) Generally effective ( ) Generally ineffective ( ) Extremely ineffective ( ) Not applicable ( )

ADDITIONAL COMMENTS:

4. Customer Satisfaction.

a. To what extent did the contractor provide timely assistance, when responding to problems?

Considerably surpassed minimum requirements ( ) Exceeded minimum requirements ( ) Met minimum requirements ( ) Less than minimum requirements ( ) Not applicable ( )

b. How would you rate the contractor's response to inquiries related to administrative issues?

Displayed considerable initiative ( ) Displayed some initiative ( ) Displayed little initiative ( ) Displayed no initiative ( ) Not applicable ( )

c. Would you select this contractor again?

( ) Yes ( ) No

ADDITIONAL COMMENTS:

CONTROLLED UNCLASSIFIED INFORMATION

FORM PPEP C

PAST PERFORMANCE QUESTIONNAIRE

5. Integrity.

a. Did you experience any integrity problems with this Contractor?

( ) Yes ( ) No

b. Did the contractor maintain integrity during contract performance?

( ) Yes ( ) No

ADDITIONAL COMMENTS:

6. Please provide any other comments you may have.

CONTROLLED UNCLASSIFIED INFORMATION

FORM PPEP C

PAST PERFORMANCE SCORING KEY

1. Quality/Timeliness of Service.

a. How would you rate the contractor's general overall compliance with contract requirements?

Considerably surpassed minimum requirements ( ) 4 Exceeded minimum requirements ( ) 3 Met minimum requirements ( ) 2 Less than minimum requirements ( ) 1 Not applicable ( ) 0

b. How would you rate the timeliness of the Contractor's service - delivered reports on time and adhering to the required schedule?

Considerably surpassed minimum requirements ( ) 4 Exceeded minimum requirements ( ) 3 Met minimum requirements ( ) 2 Less than minimum requirements ( ) 1 Not applicable ( ) 0

c. Did the contractor commit adequate resources in timely fashion to meet contract requirements?

Provided abundant resources ( ) 4 Provided sufficient resources ( ) 3 Provided minimal resources ( ) 2 Provided insufficient resources ( ) 1 Not applicable ( ) 0

d. Did the contractor commit adequate resources in timely fashion to solve problems?

Provided abundant resources ( ) 4 Provided sufficient resources ( ) 3 Provided minimal resources ( ) 2 Provided insufficient resources ( ) 1 Not applicable ( ) 0

e. How would you rate the contractor on the timeliness of its responses to inquiries or other administrative matters?

Extremely timely ( ) 4 Generally timely ( ) 3 Generally not timely ( ) 2 Seldom timely ( ) 1 Not applicable ( ) 0

CONTROLLED UNCLASSIFIED INFORMATION

FORM PPEP C

PAST PERFORMANCE SCORING KEY

2. Cost Control.

a. If applicable, to what extent did the contractor meet the proposed cost estimates?

Less than estimated cost ( ) 4 Comparatively equal to estimate ( ) 3 Exceeded the costs ( ) 2 Considerably surpassed estimate ( ) 1 Not applicable ( ) 0

b. How would you rate the contractor's initiative, if any, in reducing overall costs to the Government?

Extremely efficient ( ) 4 Generally efficient ( ) 3 Generally inefficient ( ) 2 Extremely inefficient ( ) 1 Not applicable ( ) 0

CONTROLLED UNCLASSIFIED INFORMATION

FORM PPEP C

PAST PERFORMANCE SCORING KEY

3. Business Relations - Effective Management.

a. To what extent was the contractor able to solve contract performance problems without extensive guidance from government (or entity with requirement) counterparts?

Considerably successful ( ) 4 Generally successful ( ) 3 Little Success ( ) 2 No success ( ) 1 Not applicable ( ) 0

b. To what extent did the contractor display initiative in meeting contract requirements?

Displayed considerable initiative ( ) 4 Displayed some initiative ( ) 3 Displayed little initiative ( ) 2 Displayed no initiative ( ) 1 Not applicable ( ) 0

c. Was the contractor's selection and use of personnel appropriate for the performance of this contract?

Provided highly qualified personnel ( ) 4 Provided qualified personnel ( ) 3 Provided minimal personnel ( ) 2 Provided insufficient personnel ( ) 1 Not applicable ( ) 0

d. To what extent was the contractor effective in interfacing with the Government's (or other) staff?

Extremely effective ( ) 4 Generally effective ( ) 3 Generally ineffective ( ) 2 Extremely ineffective ( ) 1 Not applicable ( ) 0

e. Has this contract been partially or completely terminated for default, or is a termination pending?

( ) Yes 1 ( ) No 4

f. Has it ever been necessary to send this Contractor a Notice to Cure letter?

( ) Yes 1 ( ) No 4

CONTROLLED UNCLASSIFIED INFORMATION

SIR 6973GH-22-R-00006

FORM PPEP C

PAST PERFORMANCE SCORING KEY

g. How would you rate the performance of the contractor's key personnel?

Extremely effective ( ) 4 Generally effective ( ) 3 Generally ineffective ( ) 2 Extremely ineffective ( ) 1 Not applicable ( ) 0

4. Customer Satisfaction.

a. To what extent did the contractor provide timely assistance, when responding to problems?

Considerably surpassed minimum requirements ( ) 4 Exceeded minimum requirements ( ) 3 Met minimum requirements ( ) 2 Less than minimum requirements ( ) 1 Not applicable ( ) 0

b. How would you rate the contractor's response to inquiries related to administrative issues?

Displayed considerable initiative ( ) 4 Displayed some initiative ( ) 3 Displayed little initiative ( ) 2 Displayed no initiative ( ) 1 Not applicable ( ) 0

c. Would you select this contractor again?

( ) Yes 4 ( ) No 1

5. Integrity.

a. Did you experience any integrity problems with this Contractor?

( ) Yes 1 ( ) No 4

b. Did the contractor maintain integrity during contract performance?

( ) Yes 4 ( ) No 1

SIR 6973GH-22-R-00006

FORM PPEP E

PAST PERFORMANCE SCORING/RATING SHEET

Offeror Name:

Past Performance Questionnaire Reference No.:

Contract No.:

Project Description:

RECENCY DETERMINATION:

RELEVANCY DETERMINATION:

a. Contract requirement compliance

b. Timeliness of service

c. Resource commitment for requirement

d. Resource commitment for problem solving

e. Timeliness of responses

Question 1 Average Score: 0.00 0.00 0.00 Question 1 Acceptability Rating:

a. Meet cost estimates

b. Initiative to reduce costs

Question 2 Average Score: 0.00 0.00 0.00 Question 2 Acceptability Rating:

a. Performance problem solving

b. Initiative to meet requirement

c. Selection and use of personnel

d. Effective interface with Government

e. Contract termination

f. Cure Notice letter issued

g. Key personnel performance

Question 3 Average Score: 0.00 0.00 0.00 Question 3 Acceptability Rating:

a. Timely assistance to problem response

b. Response to administrative issues

c. Select contractor again

Question 4 Average Score: 0.00 0.00 0.00 Question 4 Acceptability Rating:

a. Integrity problems experienced

b. Integrity maintained during contract performance

Question 5 Average Score: 0.00 0.00 0.00 Question 5 Acceptability Rating:

TOTAL FACTOR AVERAGE SCORE: 0.00 0.00 0.00

TOTAL FACTOR ACCEPTIBILITY RATING: 0.00 0.00 0.00

Question 5 - Integrity

Question 1 - Quality and Timeliness of Service

Question 2 - Cost Control

Question 3 - Business Relations - Effective Management

Question 4 - Customer Satisfaction

Note: The above Excel spreadsheet must be modified to add columns for the appropriate number of questionnaire responses received.

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