Attachment 3 - Past Performance Questionnaire(PPQ) - HVAC Air Hansdler Replacement.docx

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

HVAC Air Handler Replacement | Starbucks, Travis Air Force Base, CA

Solicitation No. FA442726Q1070

The 60th Contracting Squadron, Travis Air Force Base, CA is in the process of soliciting offers from companies capable of providing - Starbucks HVAC air handler replacement.

INSTRUCTIONS

TO THE CONTRACTOR (Offeror): Complete Section A in full of accurate project details, then provide this form to your client for reference for completion of Sections B and C. Submit completed PPQs with your quote or arrange for your reference to submit directly to the Contract Specialist or Contracting Officer Below.

TO THE REFERENCE (Client): The contractor listed below has included this project as a past performance reference. Please complete Sections B and C honestly and return the completed form to the contractor (for submission with their quote or arrange for your reference to submit directly to the Contract Specialist or Contracting Officer Below.). The Government reserves the right to verify all information provided.

SECTION A – CONTRACT INFORMATION

TO BE COMPLETED BY THE CONTRACTOR (Offeror) BEFORE SENDING TO REFERENCE

Contractor/Company Name:

Contract / Order Number:

Project Title / Description:

Contracting Agency / Customer:

Period of Performance:

Start: ________________ End: ________________ Contract Dollar Value:

Place of Performance:

Contractor POC Name / Phone / Email:

Brief Description of Work (relevance to HVAC installation/replacement):

SECTION B – REFERENCE INFORMATION

TO BE COMPLETED BY THE REFERENCE (Previous Customer/Client)

Reference Name:

Title:

Organization / Agency:

Phone Number:

Email Address:

Date Completed:

SECTION C – PERFORMANCE RATINGS

TO BE COMPLETED BY THE REFERENCE – Check (☒) one rating per category.

SECTION D – NARRATIVE COMMENTS

TO BE COMPLETED BY THE REFERENCE

SECTION E – REFERENCE CERTIFICATION & SIGNATURE

I certify that the information provided in this questionnaire is accurate and complete to the best of my knowledge. I understand the Government may contact me to verify this information.

Reference Signature:

Signature Date:

MM / DD / YYYY

Printed Name:

Title:

RETURN COMPLETED FORM TO:

The Contract Specialist: SrA Nadine Umunyana/ Email: nadine.umunyana.1@us.af.mil and Contracting Officer: SSgt John R. De Pedro / Email: john_rexter.de_pedro@us.af.mil.mil| OR return to the contractor for inclusion with their quote submission.

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