Attachment 16 - Past Performance Information Sheet - DRAFT.pdf
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- Joint Base San Antonio Multiple Award Construction Contract (MACC) IDIQ Federal contract opportunity
- Solicitation number
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About this file
This document contains a draft past performance assessment form to be completed for federal contracts. The form requests information on the offeror, references, contract details including value and modifications, description of work as prime or subcontractor, relationship to current work, performance assessment, technical issues, and points of contact. Offerors are to provide a separate completed form for each referenced contract, with additional space as needed. Unfavorable performance is to be addressed by explaining fixes and corrective actions taken. No ratings or reports should be repeated from the Contractor Performance Assessment Reporting System if the rationale has not changed.
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FA301621R0017 Page 1 of 5
Attachment # 16 - PAST PERFORMANCE
INFORMATION FORM (PPIF)
Past Performance Reference No.
Provide the information requested in this form for each one of the present or past contracts you have identified. Provide a separate completed form for each contract identified. Attach a separate sheet if additional space is needed.
A. Current Offeror (Company/Division):
CAGE Code:
DUNS Number:
(NOTE: If the company or division performing this past or present effort is different from the current Offeror, note this fact below. Refer to the "Organizational Structure Change History" you provided as part of your Past Performance Volume).
B. Project Title:
C. Contract Specifics:
1. Complete Name of Customer:
2. Customer Address and Telephone #:
3. Contract Number or Citation:
4. Type of Contract:
5. Period of Performance:
6. Initial Contract Price: $
7. Final Amount Invoiced/Amount Invoiced to Date: $
8. Original completion date:
9. Current scheduled completion date:
10. Estimated completion date:
OR Estimated Percent Completion:
11. Number of contract modifications:
12. Enter primary cause for contract changes below:
DRAFT
FA301621R0017 Page 2 of 5
D. Description of Work Prime or Subcontractor.
E. Describe how the work under this contract relates to the experience cited by the Offeror in its present proposal.
FA301621R0017 Page 3 of 5
F. Self-Assessment of past performance record. Provide information of any problems encountered and your corrective actions.
G. Address below any technical (or other) issues about this contract considered particularly relevant to the current solicitation.
H. Summarize contract issues relative to the number and severity of quality deficiencies recorded/contract discrepancy reports issued, cure notices, show cause letters, termination for default or cause, disputes, claims, latent defects; and corrective actions taken for this contract reference.DRAFT
FA301621R0017 Page 4 of 5
I. Current Status of Contract (Select as applicable):
[ ] Work Continuing – On Schedule
[ ] Work Continuing – Behind Schedule
[ ] Work Completed – Litigation Pending or Underway
[ ] Work Completed – No Further Action Pending or Underway
[ ] Work Completed – Routine Administrative Action Pending or Underway
[ ] Request For Equitable Adjustment(s) Negotiations Pending or Underway
[ ] Claims Negotiations Pending or Underway
[ ] Terminated for Convenience
[ ] Terminated for Default
[ ] Other (Explain)
J. Primary customer points of contact. (For Government contracts/orders, provide current information on all three individuals. For commercial contracts, provide points of contact filling these same roles.)
1. Program Manager and/or Site Manager
2. Procurement Contracting Officer
3. Administrative Contracting Officer
Name:
Office:
Address:
Telephone:
FAX #:
E-Mail:
FA301621R0017 Page 5 of 5
Additionally, for those efforts where the offeror is cognizant of unfavorable and/or marginal past performance ratings/reports previously assessed by customers or clients, but feel that significant progress has been made but not yet credited or formally documented, provide the program name, contract number, customer location and a narrative explaining "fixes" made to date, or any other information regarding the unfavorable/marginal assessment.
It is not presumed that the offeror's performance has been perfect. Rather, the proposal should contain evidence of the offeror's ability to isolate the root causes of problems and should describe programs or actions taken to resolve those causes. Demonstrated corrective actions (not just planned or promised), and the overall work record will be considered. Problems not addressed by the offeror, but found by the Government during the evaluation of the information in this volume, will be assumed to still exist. Note: In the case of Contractor Performance Assessment Report System (CPARS), if your input has already been provided and the rationale/circumstances have not changed, DO NOT repeat them here.
| Past Performance Reference NoAttachment 9 PAST PERFORMANCE INFORMATION FORM PPIF: |
| Provide the information requested in this form for each one of the present or past contracts you have identified Provide a separate completed form for each contract identified Attach a separate sheet if additional space is neededRow1: |
| A Current Offeror CompanyDivision: |
| CAGE Code: |
| DUNS Number: |
| NOTE If the company or division performing this past or present effort is different from the current Offeror note this fact below Refer to the Organizational Structure Change History you provided as part of your Past Performance Volume: |
| B Project Title: |
| 1 Complete Name of Customer: |
| 2 Customer Address and Telephone: |
| 3 Contract Number or Citation: |
| 4 Type of Contract: |
| 5 Period of Performance: |
| fill_20: |
| fill_21: |
| 8 Original completion date: |
| 9 Current scheduled completion date: |
| 10 Estimated completion date: |
| OR Estimated Percent Completion: |
| 11 Number of contract modifications: |
| D Description of Work Prime or SubcontractorRow1: |
| E Describe how the work under this contract relates to the experience cited by the Offeror in its present proposalRow1: |
| F SelfAssessment of past performance record Provide information of any problems encountered and your corrective actionsRow1: |
| I Address below any technical or other issues about this contract considered particularly relevant to the current solicitationRow1: |
| J Summarize contract issues relative to the number and severity of quality deficiencies recordedcontract discrepancy reports issued cure notices show cause letters termination for default or cause disputes claims latent defects and corrective actions taken for this contract referenceRow1: |
| 1 Program Manager andor Site ManagerName: |
| 2 Procurement Contracting OfficerName: |
| 3 Administrative Contracting OfficerName: |
| 3 Administrative Contracting OfficerOffice: |
| 1 Program Manager andor Site ManagerAddress: |
| 2 Procurement Contracting OfficerAddress: |
| 3 Administrative Contracting OfficerAddress: |
| 1 Program Manager andor Site ManagerTelephone: |
| 2 Procurement Contracting OfficerTelephone: |
| 3 Administrative Contracting OfficerTelephone: |
| 1 Program Manager andor Site ManagerFAX: |
| 2 Procurement Contracting OfficerFAX: |
| 3 Administrative Contracting OfficerFAX: |
| 1 Program Manager andor Site ManagerEMail: |
| 2 Procurement Contracting OfficerEMail: |
| 3 Administrative Contracting OfficerEMail: |
| Additionally for those efforts where the offeror is cognizant of unfavorable andor marginal past performance ratingsreports previously assessed by customers or clients but feel that significant progress has been made but not yet credited or formally documented provide the program name contract number customer location and a narrative explaining fixes made to date or any other information regarding the unfavorablemarginal assessment It is not presumed that the offeror s performance has been perfect Rather the proposal should contain evidence of the offeror s ability to isolate the root causes of problems and should describe programs or actions taken to resolve those causes Demonstrated corrective actions not just planned or promised and the overall work record will be considered Problems not addressed by the offeror but found by the Government during the evaluation of the information in this volume will be assumed to still exist Note In the case of Contractor Performance Assessment Report System CPARS if your input has already been provided and the rationalecircumstances have not changed DO NOT repeat them hereRow1: |
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| Check Box2: Off |
| Text3: |
| Check Box4: Off |
| Check Box5: Off |
| Check Box6: Off |
| Check Box7: Off |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
| Check Box11: Off |
| Check Box12: Off |
| Check Box13: Off |
| 1 Program Manager andor Site ManagerOffice: |
| 2 Procurement Contracting OfficerOffice: |
File details come from the government source that posted it. Updated .