NIST AMD TEAM-E/BOULDER PAST PERFORMANCE QUESTIONNAIRE (Form PPQ)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information Firm Name:

Address:

CAGE Code:

UEI Number:

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: D Prime Contractor D Sub Contractor D Joint Venture D Other (Explain) Percent of project work performed:

If subcontractor, who was the prime (Name/Phone#):

3. Contract Information

Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: D Firm Fixed Price D Cost Reimbursement D Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work D High □ Med D Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

CLIENT INFORMATION (Client to complete Blocks 5-8)

5. Client Information Name:

Title:

Phone Number:

Email Address:

6. Describe the client's role in the project:

7. Date Questionnaire was completed (mm/dd/yy):

8. Client's Signature:

NOTE: THE CONTRACTING OFFICER REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS

DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE COMPLETED QUESTIONNAIRE TO THE

CONTRACTING OFFICER WITH THEIR PROPOSAL, AND MAY DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION

ON NIST AMD TEAM-E/BOULDER SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES

DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY BE SUBMITTED DIRECTLY TO THE NIST AMD TEAM-

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RATING

(E) Excellent

(VG) Very Good

(S) Satisfactory

(M) Marginal

(U) Unsatisfactory

(N) Not Applicable

E/BOULDER CONTRACTING OFFICER. PLEASE CONTACT THE OFFEROR FOR CONTRACTING OFFICER POINT OF CONTACT

INFORMATION. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON TIDS FORM.

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR'S PERFORMANCE

DEFINITION NOTE

Performance meets contractual requirements and An Exceptional rating is appropriate when exceeds many to the Government/Owner's the Contractor successfully performed benefit. The contractual performance of the multiple significant events that were of element or sub-element being assessed was benefit to the Government/Owner. A accomplished with few minor problems for which singular benefit, however, could be of such corrective actions taken by the contractor was magnitude that it alone constitutes an highly effective. Exceptional rating. Also, there should have been NO significant weaknesses identified.

Performance meets contractual requirements and A Very Good rating is appropriate when the exceeds some to the Government's/Owner's Contractor successfully performed a benefit. The contractual performance of the significant event that was a benefit to the element or sub-element being assessed was Government/Owner. There should have accomplished with some minor problems for been no significant weaknesses identified.

which corrective actions taken by the contractor were effective.

Performance meets minimum contractual A Satisfactory rating is appropriate when requirements. The contractual performance of the there were only minor problems, or major element or sub-element contains some minor problems that the contractor recovered from problems for which corrective actions taken by the without impact to the contract. There contractor appear or were satisfactory. should have been NO significant weaknesses identified. Per DOC policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract/ order.

Performance does not meet some contractual A Marginal is appropriate when a requirements. The contractual performance of the significant event occurred that the element or sub-element being assessed reflects a contractor had trouble overcoming which serious problem for which the contractor has not impacted the Government/Owner.

yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented.

Performance does not meet most contractual An Unsatisfactory rating is appropriate requirements and recovery is not likely in a timely when multiple significant events occurred manner. The contractual performance of the that the contractor had trouble overcoming element or sub-element contains serious and which impacted the problem(s) for which the contractor's corrective Government/Owner. A singular problem, actions appear or were ineffective. however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

No information or did not apply to your contract Rating will be neither positive nor negative.

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TO BE COMPLETED BY CLIENT

PLEASE CIRCLE THE ADJECTIVE RA TING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR'S PERFORMANCE.

1. QUALITY:

a) Quality of technical data/report preparation efforts. E VG s M u N

b) Ability to meet quality standards specified for technical performance. E VG s M u N

c) Timeliness/effectiveness of contract problem resolution without extensive E VG s M u N customer guidance.

d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on E VG s M u N performance).

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or E VG s M u N the schedule was not met, please address below)

b) Rate the contractor's use of available resources to accomplish tasks E VG s M u N identified in the contract.

3. CUSTOMER SATISFACTION:

a) To what extent were the end users satisfied with the project? E VG s M u N

b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; E VG s M u N responsiveness to administrative reports, businesslike and communication).

c) To what extent was the contractor cooperative, businesslike, and concerned E VG s M u N with the interests of the customer?

d) Overall customer satisfaction. E VG s M u N

4. MANAGEMENT/ PERSONNEL/LABOR:

a) Effectiveness of on-site management, including management of E VG s M u N subcontractors, suppliers, materials, and/or labor force?

b) Ability to hire, apply, and retain a qualified workforce to this effort.

E VG s M u N

c) Government Property Control. E VG s M u N

d) Knowledge/expertise demonstrated by contractor personnel. E VG s M u N

e) Utilization of Small Business concerns (Not applicable to contracts E VG s M u N performed in Japan).

f) Ability to simultaneously manage multiple projects with multiple E VG s M u N disciplines.

g) Ability to assimilate and incorporate changes in requirements and/or E VG s M u N priority, including planning, execution and response to Government changes.

h) Effectiveness of overall management (including ability to effectively lead, manage and control the program). E VG s M u N

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5. COST/FINANCIAL MANAGEMENT:

a) Ability to meet the terms and conditions within the contractually agreed E VG s M u N price(s)?

b) Contractor proposed innovative alternative methods/processes that reduced E VG s M u N cost, improved maintainability or other factors that benefited the client.

c) If this is/was a Government cost type contract, please rate the Contractor's timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance E VG s M u N with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns).

d) Is the Contractor's accounting system adequate for management and Yes No tracking of costs? If no, please explain in Remarks section.

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending

Yes No terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

t) Have there been any indications that the contractor has had any financial Yes No problems? If yes, please explain below.

6. SAFETY/SECURITY:

a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues?

E VG s M u N (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

b) Contractor complied with all security requirements for the project and E VG s M u N personnel security requirements.

7.GENERAL:

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner E VG s M u N regarding urgent contractual issues).

b) Compliance with contractual terms/provisions (explain if specific issues). E VG s M u N

c) Would you hire or work with this firm again? (If no, please explain below) Yes No

d) In summary, provide an overall rating for the work performed by this E VG s M u N contractor.

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Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):

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