Attachment 2 - Past Performance Questionnaire.pdf
PDF 590 KB Posted
- Attached to
- U. S. Senate Wellbeing Application
- Solicitation number
- 2027-R-007
- Issued by
-
United States Senate
About this file
This is a Past Performance Questionnaire (PPQ) template issued by the U.S. Senate Sergeant at Arms (SAA) for evaluating contractor performance on past contracts relevant to Solicitation 2027-R-007 for a Customizable Employee Wellbeing Application. The questionnaire is designated as source selection information and must be treated as procurement sensitive. Offerors are required to submit completed questionnaires within five (5) business days of receipt to acquisitions@saa.senate.gov, Attn: Tonia Courtney, Senior Procurement and Contracting Specialist.
The questionnaire requires offerors to identify contract and project information, including the contractor name, contract/task order number, contract type, project name, period of performance, and work description. References from the customer organization must provide their company/agency name, contact information, role in contract management, and time period of involvement. References rate contractor performance across eight core evaluation criteria using a six-point scale: Exceptional (EX), Very Good (VG), Satisfactory (S), Marginal (MG), Unsatisfactory (US), and Not Applicable/Not Observed (N/A). Evaluation areas include fulfillment of contract requirements and specifications, delivery schedule performance, problem identification and corrective actions, personnel expertise and quality, key personnel selection and retention, program management effectiveness, cost forecasting and management, and an overall assessment. The questionnaire concludes with a yes/no question regarding future contracting willingness and an open-ended section for additional performance comments.
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Text version
SOURCE SELECTION INFORMATION
PPQ V3 | May 2022
Attachment - 2
PAST PERFORMANCE QUESTIONNAIRE
The U.S. Senate Sergeant at Arms (SAA) requests information in support of a contract for a Customizable Employee Wellbeing Application, Solicitation 2027-R-007.
When complete, the information on this form is SOURCE SELECTION INFORMATION and shall be protected as procurement sensitive information. Please complete this questionnaire and send within five (5) days of receipt by email to:
acquisitions@saa.senate.gov Attn: Tonia Courtney Senior Procurement and Contracting Specialist
A. Contract/Project/Task Order Information. Offeror must complete the information below regarding the contract on which the offeror is seeking a past performance reference:
Name of Offeror/Subcontractor: __________________________________________________
Contract/Task Order Number: _____________________________________________________
Contract Type: _________________________________________________________________
Project Name: _________________________________________________________________
Period of Performance: __________________________________________________________
Brief Description of Work:
mailto:acquisitions@saa.senate.gov
Attachment - 2
SOURCE SELECTION INFORMATION
PPQ V3 | May 2022
B. Reference Information. Reference must complete the information below regarding the contract on which the offeror is seeking a past performance reference:
Company/Agency Name: _________________________________________________________
Name of Person Completing Questionnaire: __________________________________________
Signature of Person Completing Questionnaire: _______________________________________
Your Role in Managing this Contract:_______________________________________________
Your Phone Number: ___________________________________________________________
Your Email Address: ____________________________________________________________
Time Period of Your Involvement with Contractor: ____________________________________
For each question posed below, please identify (highlight or underline) the response code which best reflects your experience with the referenced contract:
EX Exceptional -- Performance meets contractual requirements and exceeds many to the Company/Agency’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.
VG Very Good -- Performance meets contractual requirements and exceeds some to the Company/Agency’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
S Satisfactory -- 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 appear or were satisfactory.
MG Marginal -- Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.
US Unsatisfactory -- 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.
N/A Not Applicable or Not Observed
SOURCE SELECTION INFORMATION
PPQ V3 | May 2022
PAST PERFORMANCE QUESTIONNAIRE Solicitation 2026-R-066
1. Assess the contractor’s performance fulfilling contract requirements and specifications.
EX VG S MG US N/A
Comments:
2. Assess the ability of the contractor to deliver goods and services according to contract schedules.
EX VG S MG US N/A
Comments:
3. Assess the contractor’s performance in identifying problems and taking corrective actions.
EX VG S MG US N/A
Comments:
4. Assess the overall expertise, knowledge, and quality of assigned contractor personnel.
EX VG S MG US N/A
Comments:
SOURCE SELECTION INFORMATION
PPQ V3 | May 2022
5. Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.
EX VG S MG US N/A
Comments:
6. Assess the effectiveness of the contractor’s overall program management.
EX VG S MG US N/A
Comments:
7. Assess the contractor’s effectiveness in forecasting and managing contractual costs.
EX VG S MG US N/A
Comments:
8. Overall assessment. EX VG S MG US N/A
Comments:
SOURCE SELECTION INFORMATION
PPQ V3 | May 2022
9. Would you contract with this contractor again? ( ) Yes ( ) No
If no, why not?
10. Please provide any further comments that are pertinent to the contractor’s performance.
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