Attachment 2 (PPQ).docx

PAST PERFORMANCE QUESTIONNAIRE

The Defense Health Agency (DHA) Contracting Activity (DHACA) Healthcare Contracting Division-West (HCD-W) is conducting a 100% Service-Disabled Veteran-Owned Small Business (SDVOSB) Set-Aside. The offeror has identified you as a reference to validate past performance.

Solicitation Number, HT941026Q2047 is for nonpersonal services of one (1) FTE Food Service Worker at the Mike O’Callaghan Military Medical Center (MOMMC), Nellis AFB, Nevada.

Please complete the following questionnaire to assist our evaluation of the Contractor’s past performance, and return via email no later than 10:00am Pacific on Monday, August 10th, 2026 to dominic.n.gonzales.civ@health.mil.

RESPONDENT INFORMATION:

Contracting Activity/Customer:

Point of Contact (POC):

Title of POC:

Telephone:

Email:

OFFEROR’S REFERENCE INFORMATION:

Contractor Name:

Point of Contact (POC):

Telephone Number:

Email:

CONTRACT INFORMATION:

Contract Number:

Task Order Number:

Type of Contract:

Performance Period: (Base plus any options):

Description of Services:

MARKET SEGMENT

Food Service

MAGNITUDE

Annual Contract Value:

Total Contract Dollar Value:

COMPLEXITY

Number of FTEs:

Facility Type (i.e., Hospital/Clinic):

Contractor performed on this contract as:

Please refer to the following assessment definitions to assess the Contractor’s performance in each of the areas listed in this questionnaire:

(E) Exceptional - The Contractor’s performance meets contractual requirements and exceeds many (requirements) to the Government’s benefit. The contractual performance was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective.

(V) Very Good - The Contractor’s performance meets contractual requirements and exceeds some (requirements) to the Government’s benefit. The contractual performance was accomplished with some minor problems for which corrective actions taken by the Contractor were effective.

(S) Satisfactory - The Contractor’s performance meets contractual requirements. The contractual performance contained some minor problems for which corrective actions taken by the Contractor appear or were resolved satisfactorily.

(M) Marginal - Performance does not meet some contractual requirements. The contractual performance 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.

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

(N) Not Applicable – Unable to assess the area.

Overall Quality of Service (CPARS “Quality of Service” Rating Area)

Provided qualified Food Service Worker(s) in accordance with the terms and conditions of the contract.

Ensured that Food Service Worker(s) performed duties effectively and efficiently, meeting service standards (e.g., food preparation, sanitation, customer service).

Maintained a high standard of service quality and customer satisfaction in food service operations.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Timeliness and Responsiveness (CPARS “Schedule” Rating Area)

Provided Food Service Worker(s) on time in accordance with the terms and conditions of the contract.

Ensured timely and accurate submission of all required documentation (e.g., personnel records, reports).

Responded promptly and effectively to scheduling changes or operational needs related to food service.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Management and Personnel Stability (CPARS “Management” Rating area)

Retained qualified Food Service Worker(s) with minimal turnover, ensuring continuity of food service operations in accordance with the terms of the contract.

Effectively managed personnel, including addressing performance issues and ensuring compliance with contract requirements.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Continuity of Operations (CPARS “Management” Rating area)

Planned for and provided replacement personnel during the life of the contract, including for pre-planned/unplanned absences and extended leave, to avoid disruption of food service operations and/or work schedule in accordance with the terms of the contract.

Demonstrated effective communication and coordination with Government personnel regarding staffing and operational matters.

If other than “Satisfactory,” explain how the performance exceeds or does not meet contractual requirements:

Would you award this firm another contract:

If you answered “No” provide an explanation:

Was the contract terminated for default or cause:

If you answered “Yes” provide an explanation:

Additional Comments:

Signature: _________________________________________ Date: __________________

Print Name: _________________________________________

Title: _______________________________________________

Telephone: __________________________________________

Thank you for your participation in providing a detailed and accurate history of past performance for this offeror.