Attachment_5_-_Past_Performance_Questionnaire.pdf

ATTACHMENT 5

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Solicitation No.: 140D0426Q0750

Project Title: Historical Preservation Training Center President’s House Reinforced Masonry Barrier Wall

Instructions

The Offeror shall provide this Past Performance Questionnaire (PPQ) to a client representative who is familiar with the Offeror's performance on the referenced project.

The Government will use the information provided to evaluate the Offeror's past performance.

If the Offeror is unable to obtain a completed Past Performance Questionnaire (PPQ) from a client before the proposal due date, the Offeror shall complete and submit the first page of the PPQ with its proposal. The first page must include the applicable contract and client information for the referenced project(s). The Government may contact the client directly to obtain the completed PPQ or to verify the past performance information provided.

Completed questionnaires may be submitted with the proposal or emailed directly to the Government Point(s) of Contact identified in the solicitation.

SECTION I – TO BE COMPLETED BY THE OFFEROR

Offeror Information

Offeror Name: ___________________________________________

Address: ________________________________________________

Project Manager: __________________________________________

Phone: _________________________________________________

Email: _________________________________________________

Referenced Contract Information

Project Name: ___________________________________________

Contract Number: ________________________________________

Owner/Agency: ___________________________________________

Project Location: ________________________________________

Contract Type

☐ Prime Contractor

☐ Subcontractor

☐ Joint Venture

☐ Other ______________________

Period of Performance

Start Date __________________

Completion Date __________________

Original Contract Value

Final Contract Value

Description of Similar Work

Describe the project and identify work similar to this solicitation.

☐ Reinforced Masonry Walls

☐ Structural Masonry

☐ Concrete Foundations

☐ Site Improvements

☐ Historic Preservation

☐ Work in Historically Sensitive Environments

Project Description

Subcontractor or Affiliate Information (If Applicable)

If this project is submitted to demonstrate the experience of a subcontractor or affiliate, describe:

• The firm's role on the referenced contract.

• The proposed role under this solicitation.

• How its workforce, management, equipment, facilities, or other resources will be utilized.

Attach Letter of Commitment or Teaming Agreement.

Client Reference

Organization

Reference Name

Title

Phone

Email

SECTION II – TO BE COMPLETED BY CLIENT/OWNER

Please rate the contractor's performance using the following scale.

Rating Meaning

Excellent Significantly exceeded requirements

Very Good Exceeded requirements

Satisfactory Met requirements

Marginal Occasionally failed to meet requirements

Unsatisfactory Failed to meet requirements

N/A Not Applicable

Performance Evaluation

1. Quality of Work

☐ Excellent ☐ Very Good ☐ Satisfactory ☐ Marginal ☐ Unsatisfactory ☐ N/A

Comments

2. Schedule Performance

3. Cost Control

4. Construction Management

5. Reinforced Masonry Construction

6. Structural Masonry Work

7. Concrete Foundations

8. Site Improvements

9. Historic Preservation / Historically Sensitive Environment

10. Safety

11. Communication and Responsiveness

12. Problem Resolution

13. Overall Performance

☐ Excellent ☐ Very Good ☐ Satisfactory ☐ Marginal ☐ Unsatisfactory

Would you award another project to this contractor?

☐ Yes

☐ No

☐ With Reservations

If "No" or "With Reservations," explain:

Additional Comments

Certification

I certify that I am familiar with this project and that the above evaluation accurately reflects the contractor's performance.

Name: _________________________________________________

Title: _________________________________________________

Organization: ___________________________________________

Phone: ________________________________________________

Email: ________________________________________________

Signature: _____________________________________________

Date: _________________________________________________