Attach 3_PPQ.pdf

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS

SOURCE SELECTION SENSITIVE INFORMATION

SEE FAR 2.101 AND FAR 3.104

FA875122R0003 Attachment 3

INSTRUCTIONS FOR OFFEROR

1. Offerors will complete Section A of the questionnaire (Pages 2 & 3) for each reference and include with their proposal. The offeror will submit Section B of the questionnaire directly to their references and request the reference return the questionnaire directly to the Contract Specialist identified below. Offeror will complete Block 2 of Section B (Contract number and Program Name) before submitting to their references.

PROPOSAL RESPONSE DATE: TBA

CONTRACT SPECIALIST

NAME: LEENA BUDHU

TEL: (315) 330-2557

EMAIL: leenawattie.budhu.1@us.af.mil mailto:leenawattie.budhu.1@us.af.mil

SOURCE SELECTION SENSITIVE INFORMATION

SEE FAR 2.101 AND FAR 3.104

SECTION A:

Offerors will complete Section A of the questionnaire (Pages 2 & 3) for each reference and include with their proposal.

1. COMPANY NAME/ REFERENCE NAME: __________________________________________

ADDRESS: ____________________________________________________________________

TEL: ___________________________ FAX: _____________________________

EMAIL: ____________________________________________________________________

2. CONTRACT #: _______________________PROGRAM NAME:____________________________

3. CONTRACTING OFFICER (IF DIFFERENT FROM REFERENCE): ________________________

ADDRESS: ____________________________________________________________________

TEL: ___________________________ FAX: _____________________________

EMAIL: ____________________________________________________________________

4. CONTRACT TYPE: Firm-Fixed Price Cost-Reimbursement Other (describe)

5. DESCRIPTION OF WORK: _______________________________________________________

6. BRIEF DESCRIPTION OF THE EFFORT Prime ____ or Subcontractor ____

SOURCE SELECTION SENSITIVE INFORMATION

SEE FAR 2.101 AND FAR 3.104

7. AWARD DATE: _______________ ___ SCHEDULED COMPLETION: ___________________

CURRENT / FINAL COMPLETION DATE (if different): _________________________________

8. AMOUNT PER YEAR: ___________________ CONTRACT TOTAL AMOUNT: ____________________

CURRENT / FINAL AMOUNT (if different): _________________________________________________

9. COMMENTS REGARDING COMPLIANCE WITH CONTRACT TERMS AND CONDITIONS

10. COMMENTS REGARDING ANY KNOWN PERFORMANCE DEEMED UNACCEPTABLE TO THE

CUSTOMER, OR NOT IN ACCORDANCE WITH THE CONTRACT TERMS AND CONDITIONS

11. LIST ALL MAJOR SUBCONTRACTORS THAT WORKED ON REFERENCED PROJECT, IN WHAT

TRADE, AND WHAT PERCENTAGE OF WORK DONE:

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IN

ACCORDANCE WITH FAR 3.104

Past Performance Questionnaire

SECTION B: Past performance reference completes this entire Past Performance Questionnaire section.

INSTRUCTIONS FOR REFERENCE

You have been identified as a past performance reference for solicitation FA875122R0003 Fire Alarm, Mass Notification & Fire Suppression Inspection, Testing & Maintenance (ITM) at the Air Force Research Laboratory, Rome NY. In order for the Government to evaluate the past performance of the Offeror identifying you as a reference, please complete Section B of this Past Performance Questionnaire, then return it to the Contract Specialist below. The Contract Number and Program Name provided by the Offeror are found in Block #2 below. If the Offeror performed additional contracts for your organization, please provide past performance information on those contracts as well.

RESPONSE DATE: TBA

LEENA BUDHU, CONTRACT SPECIALIST

AFRL/RIKO

26 ELECTRONIC PKWY

ROME NY 13441-4514

TEL: (315) 330-2557

E-MAIL: leenawattie.budhu.1@us.af.mil

The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable. Thank you for your assistance.

1. NAME: ____________________________________________________________________

POSITION: ____________________________________________________________________

ADDRESS: ____________________________________________________________________

TEL: ___________________________ FAX: _____________________________

EMAIL: ____________________________________________________________________

2. CONTRACT #: _______________________PROGRAM NAME:___________________________

3. RELATIONSHIP AND TIME INVOLVED WITH OFFEROR:

4. WHAT, IF ANY, ELEMENTS OF WORK WERE SUBCONTRACTED? PLEASE ESTIMATE

THE PERCENTAGE OF THE TOTAL WORK THAT WAS SUBCONTRACTED?

mailto:leenawattie.budhu.1@us.af.mil

ACCORDANCE WITH FAR 3.104

SECTION B, CONTINUED: Please rate the offeror’s performance using the scale below.

E VG S M U N

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets contractual requirements.

The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

does not meet some contractual requirements.

The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

was not observed or not applicable to the current effort being reported against.

EVALUATION AREAS

I. Quality E VG S M U N

1.

Contractor provided effective quality control and inspection procedures that resulted in a quality-finished project.

2. Contractor developed and submitted realistic progress goals.

3. Contractor provided materials and products that met or exceeded contract requirements.

4.

Contractor completed all work with good workmanship and in conformance with the specifications, resulting in minor, if any, punch list items.

5.

Performance was cost effective. There were minimal cost increases to the original negotiated amount. If there were significant changes, please explain below.

ACCORDANCE WITH FAR 3.104

FA875122R0003 Attachment 3

Comments:

II. Timely Performance E VG S M U N

Contractor met established frequency requirements to complete the project on time and to ensure quality results.

2.

Contractor performed all work without the issuance of a cure notice or show cause letter. (If a notice was issued, please describe the circumstances in the comments section and identify how the situation was resolved.)

3. Contractor provided timely proposals and responses to contract changes, if any.

4. Contractor submitted progress schedules and interim progress reports, as required, in a timely manner.

5. Contractor provided submittals on time as required.

6. Contractor provided timely resolution of all punch list items.

III. Management Effectiveness E VG S M U N

Contractor provided experienced, qualified managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2. Contractor hired quality subcontractors and effectively managed and coordinated their work.

4.

Contractor ensured the site superintendent had sufficient authority to make decisions and take actions during project performance to keep the project on schedule.

5. Contractor provided timely and satisfactory response to warranty issues after project completion.

6. Contractor paid employees/subcontractors/suppliers fully and on time.

7.

Contractor cooperated to resolve problems, attended meetings, and maintained effective communication to ensure satisfactory resolution.

ACCORDANCE WITH FAR 3.104

FA875122R0003 Attachment 3

IV. Contract Administration E VG S M U N

1. Contractor provided complete and correct documentation in a timely manner.

2.

Contractor was responsive during contract performance on administrative issues.

V. Compliance with Safety Standards E VG S M U N

1. Adequacy of Safety Plan.

2. Implementation of Safety Plan.

3.

Safe work habits demonstrated through proper and adequate use of protective equipment and job site protection to maintain accident-free work zone.

4. Response to incidents was timely, reports were made as required, and collateral risk was mitigated promptly. If no incidents for the project, write N/A.

VI. Overall Performance E VG S M U N

1. Please rate the contractor’s overall performance.

ADDITIONAL COMMENTS (attach additional sheets as necessary):