Attachment 4 Past Performance Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

Solicitation Number:

The requests your assistance in support of a source selection.

Please complete this Past Performance Questionnaire (PPQ) and return it by _______ AM central time on ___________________.

PPQ’s shall be returned to:

Email:

PPQ’s shall NOT be provided to the Offeror whose performance is being evaluated.

When completed, the information in this PPQ becomes SOURCE SELECTION SENSITIVE in accordance with 41 U.S.C. 423, and shall be protected accordingly.

TO BE COMPLETED BY OFFEROR

1) Offeror Name & Complete Address:

The following blocks shall identify the contract between the Offeror and the Reference Organization. Referenced contract must be for services that are recent (within ___ months) and relevant (similar scope, complexity and magnitude) to the services being requested in the solicitation.

2) Contract Number:

3) Contract Period of Performance

(Start date – end date):

4) Total Contract Value (including options):

5) Contract Type (i.e. Firm-Fixed Price, Time & Material, Labor Hour):

6) Description of Services provided under referenced contract (include enough detail to determine relevance to requested services):

to

Attachment #4

TO BE COMPLETED BY REFERENCE ORGANIZATION

7) Evaluator’s Name & Title:

8) Evaluator’s Phone Number:

9) Evaluator’s Email Address:

10) Duration of Business Relations with Offeror’s Firm (years/months):

11) Please select the response which best reflects your experience on the referenced contract.

Indicate the extent to which the contractor met, exceeded, or did not meet your expectations.

a) Quality (Consider the extent to which the services performed by the Offeror's firm met the contract requirements.)

Comments on Quality:

b) Schedule (Consider adherence to schedule, flexibility in scheduling, coordinating schedule with building manager)

Comments on Schedule:

c) Business Relations (Consider commitment to customer satisfaction, responsiveness, problem resolution, process improvement, incorporation of lessons learned.)

Comments on Business Relations:

d) Quality of Installers (Consider technical knowledge, capability to perform the services, certifications/licenses, courtesy.)

Comments on Quality of Installers:

e) Management (Consider management of the contract, to include accuracy and timeliness of billing.)

Comments on Course Effectiveness:

f) Overall Assessment of Contractor Given your experience on this contract, would you do business with this contractor again?

12a) For any elements that were rated “Did not meet expectations,” was unsatisfactory performance shared with the contractor?

12b) If 12a was answered “yes,” communications were:

13) If not already stated above, please indicate up to three of the Offeror’s best corporate traits or observed skills.

14) If not already stated above, please indicate up to three areas where Offeror has the most room for improvement.

years months

Evaluator's Signature:

Past Performance Questionnaire Instructions

The Government Contract Specialist will enter the Solicitation Number and the Past Performance Questionnaire (PPQ) due date and time.

The Offeror (the firm submitting a proposal in response to the Government’s solicitation) shall complete the following blocks:

1) Offeror Name & Complete Address. Self-explanatory

2) Contract Number. The identifying number (if applicable) of the contract between the Offeror and the Reference Organization (the organization/company that is being asked to complete this form). Do NOT enter the solicitation number for this solicitation. The contract referenced here must be for services that are recent (within ___ months) and relevant (similar scope, complexity and magnitude) to the services being requested in the solicitation.

3) Contract Period of Performance. Enter the start and end dates of the contract referenced in block

2) above.

4) Total Contract Value. Enter the total value, including options, of the contract referenced in block

2) above.

5) Contract Type. Enter the contract type (i.e. Firm Fixed Price, Cost Reimbursement, Time & Material, Labor Hour, or other contract type) of the contract referenced in block 2) above.

6) Description of Services Provided. Provide a description of the services provided under the contract referenced in block 2) above. Provide enough detail for the Government to determine whether the referenced contract is relevant to the services being requested in the solicitation.

The Reference Organization (the organization being asked to complete this PPQ on behalf of the Offeror) shall complete the following blocks:

7) Evaluator’s Name & Title. Self-explanatory. This should be the individual within the reference organization who is most familiar with the services performed under the contract referenced in block 2).

8) Evaluator’s Phone Number. Self-explanatory.

9) Evaluator’s Email Address. Self-explanatory.

10) Duration of Business Relations with Offeror’s Firm. Enter the number of years and/or months the Evaluator (not the organization) has had a business relationship with the Offeror’s firm.

11) a) - f). Select the most appropriate response from the drop-down menu for each evaluation factor.

Please provide comments to support your ratings for elements a) – e).

12) a) and b) Select the most appropriate response from the drop-down menu for each question.

13) Self-explanatory.

14) Self-explanatory.

The Evaluator shall digitally sign and return the completed PPQ directly to the Contract Specialist, via email to .

Do NOT provide a copy of the completed PPQ to the Offeror. Once completed, this PPQ is Source Selection Sensitive information and shall be protected accordingly.