Attach 003 - Past Performance Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

SECTION I: CONTRACTOR INFORMATION

A. Your Company Name and Address:

B. Phone /Fax #: _____________________________________________________________________

C. Point of Contact/email address: ________________________________________________________

D. Authorization is hereby granted to provide the information requested in SECTION II and III of this questionnaire.

Signature of Authorized Contractor Representative Date

Printed Name and Title of Authorized Contractor Representative

SECTION II: RESPONDENT INFORMATION:

A. Client/Reference Name and Address: __________________________________________________

B. Phone/Fax #: ______________________________________________________________________

C. Point of Contact/email address: ________________________________________________________

D. Reference Contract Number: __________________________________________________________ Project Title _______________________________________________________________________ Contract Value/Type: ________________________________________________________________ Period of Performance: _______________________________________________________________ How long have you worked with the contractor: ___________________________________________ More detailed description of the work performed____________________________________________

E. Date completed: ___________________________________________________________________

Past Performance Evaluation Ratings Rating Description

Acceptable Based on the offeror’s performance record, the Government has a reasonable expectation that the offeror will successfully perform the required effort, or the offeror’s performance record is unknown

Unacceptable Based on the offeror’s performance record, the Government has no reasonable expectation that the offeror will be able to successfully perform the required effort.

Solicitation No: 12443922Q0003 Mount Rogers National Forest GWJ Grounds Maintenance

Attachment 003 - Page 1 of 2

SECTION III: PERFORMANCE EVALUATION

A. CONTRACT PERFORMANCE

1. Working relationship with your Company?

2. How well did the contractor provide experienced workers, managers and supervisors with the technical and administrative abilities needed?

A U

3. Did the contractor exhibit knowledge of and compliance with government (or other) regulations and industry standards?

A U

4. How well did the contractor provide and properly maintain operational equipment throughout the term of the contract?

A U

5. Did the contractor demonstrate the ability to hire, maintain, and replace, if necessary qualified personnel during the contract?

A U

6. How well did the contractor comply with Environmental, health, labor laws, safety and security requirements?

A U

7. How well did the contractor coordinate and control subcontractors, if any? A U

8. Contractor’s Overall Performance A U

B. QUALITY OF SERVICE/CONTROL

1. Contractor’s accomplishment in meeting the quality standards A U

2. The contractor provided an effective quality control plan or inspection procedures to meet contract requirements? If no, please explain.

A U

3. Contractor identified and corrected deficient Work A U

4. Contractor’s Overall Quality of Workmanship A U

C. TIMELINESS OF PERFORMANCE

1. How well did the contractor comply with the contract schedule? A U

2. Did the contractor provide timely and accurate records, submittals, and/or reports? A U

3. How well did the contractor resolve any delays? A U

REMARKS: For ratings of unacceptable, please provide remarks to describe the reasons for the rating. If additional remarks are necessary, please attach an additional sheet.

Attachment 003 - Page 2 of 2

ATTACHMENT 4 – Past Performance Questionnaire (PPQ)