Attachment_3_-_Past_Performance_Questionnaire.pdf

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Attached to
Mission Support Services
Solicitation number
140D0426R0115
Issued by

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This is a Past Performance Questionnaire (PPQ) template used by the U.S. Department of the Interior, Interior Business Center to evaluate contractor performance on completed or ongoing contracts.

The form collects firm information including project title, location, description, company name, contract number, start and completion dates, and initial and final contract amounts. It requires evaluator details such as name, company/agency affiliation, address, email, and role in relation to the project. The questionnaire uses a five-point rating scale: Outstanding (O), Above Average (A), Satisfactory (S), Marginal (M), and Unacceptable (U), with mandatory explanation required for Marginal or Unacceptable ratings. Evaluation areas include the contractor's relationship with the client's contract team, overall corporate management and integrity, success in meeting requirements, quality of support services and candidate competence, ability to handle unexpected changes, and quality of deliverables for analysis or project assessment work. The form also includes yes/no questions addressing whether cure notices, show cause letters, reprimands, payment suspensions, or terminations were issued; whether the evaluator would award another contract to the contractor; and whether the customer was satisfied with final products and services. The completed questionnaire must be returned to Contracting Officer Stephanie McCullough at Stephanie_McCullough@ibc.doi.gov, with notification to the requestor upon submission.

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Department of Interior Past Performance Questionnaire (PPQ)

U.S. Department of the Interior, Interior Business Center is considering award to the contractor that provided you this document. We appreciate your comments regarding this company’s past performance.

Firm Information Project Title:

Location:

Description:

Company Name: Contract Number:

Start Date: Completion Date:

Initial Amount: Final Amount:

Evaluator Evaluator Name: Company/Agency Name:

Address: POC Email:

Position Held or Function in Relation to Project:

Ratings Overview Rating: If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.

“O” Outstanding Performance greatly exceeded the contract requirements.

“A” Above Average Performance exceeded the contract requirements.

“S” Satisfactory Performance met the contract requirements.

“M” Marginal Performance met the minimum contract requirements but

Some material aspects of the contractor’s performance were less than satisfactory.

“U” Unacceptable Performance was poor and/or did not satisfy contract requirements.

Questionnaire Please select the appropriate rating and provide supporting information for the following questions.

1. The relationship between the company and client’s/customer’s contract team:

O

A

S

M

U

2. Overall corporate management, integrity, reasonableness, and cooperative conduct:

3. How successful was the Contractor in filling all requirements?

4. For support services, how would you rate the quality of the candidates provided by this Contractor in terms of technical competence, reliability, and demeanor?

5. How would you rate the Contractors ability to meet unexpected and short notice changes and/or requirements?

6. For program or project analysis/assessment requirements, how would you rate the quality of deliverables?

5. Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:

Yes

No

6. Would you award another contract to the company being evaluated? If no, please explain:

7. Was the customer satisfied with the final product and services? If no, please explain:

9. Overall Rating:

10. Comments:

Signature

Please return the signed questionnaire to the person that requested it or to the Contracting Officer, Stephanie McCulloguh at Stephanie_McCullough@ibc.doi.gov.

Please notify the requestor when the form has been submitted.

mailto:Stephanie_McCullough@ibc.doi.gov

Firm Information:
Location:
Description:
Company Name:
Contract Number:
Start Date:
Completion Date:
Initial Amount:
Final Amount:
Evaluator:
CompanyAgency Name:
Address:
POC Email:
Position Held or Function in Relation to Project:
undefined:
undefined_2:
undefined_3:
undefined_4:
undefined_5:
O_3:
A_3:
S_3:
M_3:
U_3:
3 How successful was the Contractor in filling all requirements:
undefined_6:
undefined_7:
undefined_8:
undefined_9:
undefined_10:
4 For support services how would you rate the quality of the candidates provided by this Contractor in terms of technical competence reliability and demeanor:
O_6:
A_6:
S_6:
M_6:
U_6:
undefined_11:
undefined_12:
Yes_2:
undefined_13:
No_2:
undefined_14:
Yes_3:
No_3:
9 Overall Rating:
O_8:
undefined_15:
A_8:
undefined_16:
S_8:
undefined_17:
M_8:
undefined_18:
U_8:
undefined_19:
10 Comments:
SignatureRow1:
O_7:
A_7:
S_7:
M_7:
U_7:
Text1:
Text2:

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