Attachment 4 Past Performance Questionnaire_FA930126Q0028.pdf
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- Solicitation number
- FA930126Q0028
About this file
This is a Past and Present Performance Questionnaire (PPQ) template used to collect performance feedback on contractors from government points of contact. The form is designed to be completed by individuals who have direct knowledge of a contractor's performance on a federal award and submitted to the Contracting Officer and Contract Specialist by the solicitation deadline.
The questionnaire collects general information about the contractor, including company name, address, point of contact details, project title, and description of work. It also captures award information such as award number, dollar amount, period of performance, and whether the contractor performed as a prime contractor or sub-contractor. The respondent section identifies the individual completing the form along with their title and contact information. The performance evaluation section uses a six-point rating scale—Exceptional (E), Very Good (V), Satisfactory (S), Marginal (M), Unsatisfactory (U), or Not Applicable (N/A)—with detailed definitions for each rating level. Respondents must place an "X" in the appropriate rating block and provide supporting comments explaining their assessment. The rating definitions account for the contractor's meeting of award requirements, corrective action effectiveness, minor or serious problems encountered, and relevance of the past performance effort to the current solicitation's scope and complexity. The template notes that additional pages may be attached if more space is needed for comments.
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Text version
PAST AND PRESENT PERFORMANCE QUESTIONNAIRE (PPQ)
GENERAL INFORMATION: (Please correct any inaccurate information) Contractor’s Name:
Address:
Point of Contact:
Phone Number:
Email:
Project Title:
Description of Work:
AWARD INFORMATION:
Award Number:
Dollar Amount:
Period of Performance:
Contractor performed as: �Prime Contractor �Sub-Contractor
RESPONDENT INFORMATION:
Name:
Title:
Address:
Email:
EMAIL COMPLETED QUESTIONAIRE TO THE FOLLOWING BY SOLICITATION DEADLINE:
Relevancy to:
Contract SpecialistContracting Officer
Email: Email:
Past Performance Questionnaire
PERFORMANCE INFORMATION:
In the tables below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Please provide additional comments as necessary to support your rating. Attach additional pages if more space is needed.
The performance rating scale is defined as follows:
E EXCEPTIONAL During the award period, contractor performance is meeting (or met) all award requirements and consistently exceeding (or exceeded) many. Very few, if any, minor problems encountered. Contractor took immediate and effective corrective action.
Present/past performance effort involved essentially the same scope and magnitude of effort and complexities this solicitation requires
V VERY GOOD During the award period, contractor is meeting (or met) all award requirements and consistently exceeding (or exceeded) some. Some minor problems encountered.
Contractor took timely corrective action. Present/past performance effort involved similar scope and magnitude of effort and complexities this solicitation requires
S SATISFACTORY During the award period, contractor performance is meeting (or met) all award requirements.
For any problems encountered, contractor took effective corrective action. Present/past performance effort involved some of the scope and magnitude of effort and complexities this solicitation requires
M MARGINAL During the award period, contractor performance is not meeting (or did not meet) some award requirements. For problems encountered, corrective action appeared only marginally effective, not effective, or not fully implemented.
Customer involvement was required. Present/past performance effort involved little or none of the scope and magnitude of effort and complexities this solicitation requires
U UNSATISFACTORY During the award period, contractor performance is failing/fail to meet most award requirements.
Serious problems encountered. Corrective actions were either ineffective or non-existent. Extensive Customer oversight and involvement was required. Based on the offeror’s recent/relevant performance record, the Government has no expectation that the offeror will be able to successfully perform the required effort
N/A NOT APPLICABLE Unable to provide a rating. Contractor did not include performance for this aspect, performance was not observed, or information was not available. Do not know.
Past Performance Point of Contact Signature
Additional Comments:
Page 2 of 2 Past Performance Questionnaire
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| Project Title: |
| Description of Work: |
| Contract Number: |
| Dollar Amount: |
| Contract Period or Dates of Performance: |
| Name: |
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| Check Box33: Off |
| Check Box34: Off |
| E: |
| V: |
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| M: |
| U: |
| NA: |
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| Text2: Heating Ventilation and Air Conditioning Internal Water Treatment |
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