Attachment _6 Past Performance Questionaire.docx

Attachment 6 SOL W911RX-22-R-0003, Requirement Packing and Crating, Fort Riley

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

The Contractor shall complete the company specific information on this form, contact their past performance POCs, forward this form to their past performance POCs and request that their past performance POCs complete it (verify/concur and score) and send it via email to at __selvena.b.carter.civ@army.mil (Phone: 785-304-0688). This will expedite the response from each referenced source.

Name of past performance POC organization:

Project name and contract/task order number:

Contract #:

Brief description of support provided:

1.

2.

3.

4.

5.

Total period of performance, dates,:

Total cost/price Total ______________

Number of contractor personnel assigned to the project, by skill category: Program Manager (__FTE); Assistant Program Manager (__FTE); Quality Control Manager (__ FTE); General Fillers (__ FTEs); Material Handler (__FTEs); add others as appropriate

SECTION 1:

Name and Title of Technical Point of Contact (POC):

email:

Telephone number of Technical POC: _____________________ Date the Technical POC was contacted for this PPQ: ______________

Did you inform your past performance POC that a past performance questionnaire must be completed and returned to MICC by ______ and that a MICC representative may contact him/her sometime after that date?

|_|Yes |_|No

Please BOLD the rating your Technical POC indicated he/she would give your project if contacted:

1. Overall Technical Performance

SECTION 2:

Name and Title of Contracting Point of Contact (POC):

Address of Contracting POC:

Telephone number of Contracting POC:

Date the Contracting POC was contacted for this PPQ:

Did you inform your Past Performance POC that the PPQ must be completed and returned to MICC by __________and that a MICC representative may contact him/her sometime after that date? |_|Yes |_|No

Please BOLD the rating your Contracting POC indicated he/she would give your project if contacted:

2. Would your Contracting POC use your company again? |_|Yes |_|No

Employee(s) who made the contact with above-named past performance POC references: