Attachment 2 - PPQ - Clinical Support Services.docx

ATTACHMENT 2

Request For Proposal (RFQ) # 12905B24Q0008 Clinical Support Services for Human Studies Projects –WHNRC Davis, CA

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

The Contractor shall complete the company specific information on this form, contact their clients, forward this form to their clients and request that their clients complete it (verify/concur and score) and send it via email to tonya.purce@usda.gov and copy Michael.hassett@usda.gov. This will expedite the response from each referenced source.

Name of Contractor:

Name of client organization:

Project name and contract/task order number:

Brief description of support provided:

Total period of performance, dates, and total cost/price

Number of contractor personnel assigned to the project, by skill category:

SECTION 1:

Name and Title of Technical Point of Contact (POC):

E-mail Address of Technical POC:

Telephone number of Technical POC:

Date the Technical POC was contacted for this PPQ:

Did you inform your client that a past performance questionnaire must be completed and returned to USDA by December 21, and that a USDA representative may contact him/her sometime after that date?

Yes No

Please BOLD the rating your Technical POC indicated he/she would give your project if contacted:

1. Overall Technical Performance

2. Quality of work

3. Schedule Performance

4. Cost Performance

SECTION 2:

Name and Title of Contracting Point of Contact (POC): Same as above Address of Contracting POC:

Did you inform your client that a past performance questionnaire must be completed and returned to USDA by June 17, 2023, and that a USDA representative may contact him/her sometime after that date?

Yes No

Please BOLD the rating your Contracting POC indicated he/she would give your project if contacted:

1. Overall Contractual Performance

2.Would your Contracting POC use your company again? Yes No

Employee(s) who made the contact with above-named client references: