Attachment (6) Past Performance Questionnaire (PPQ).docx

ATTACHMENT 6

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: |_| Prime Contractor |_| Sub Contractor |_| Joint Venture |_| Other (Explain) Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: |_| Firm Fixed Price |_| Cost Reimbursement |_| Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work |_| High |_| Med |_| Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

CLIENT INFORMATION (Client to complete Blocks 5-8)

5. Client Information Name:

Title:

Phone Number:

Email Address:

6. Describe the client’s role in the project:

7. Date Questionnaire was completed (mm/dd/yy):

8. Client’s Signature:

Hangar Doors, Automatic Sliding Doors, and Automatic Sliding Gate Maintenance for Naval Air Facility Misawa, Japan RFQ No. N4008426Q7004 NOTE: NAVFAC REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE COMPLETED QUESTIONNAIRE TO NAVFAC WITH THEIR PROPOSAL, AND MAY DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON NAVFAC SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY BE SUBMITTED DIRECTLY TO NAVFAC. PLEASE CONTACT THE OFFEROR FOR NAVFAC POC INFORMATION. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

Rev. Apr 2017 2 ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE 業者の評価の為の評価基準と定義

RATING DEFINITION NOTE

合を含め、契約通りの内容である。修正箇所は

非常に満足な結果である。

by the contractor were effective.

仕事が契約内容と合致しており、顧客の希望を

多少上回る。修正可能な範囲の若干の不具合を

含め、契約通りの内容である。修正箇所は満足

な結果である。

lower than Satisfactory solely for not performing beyond the requirements of the contract.

identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented.

仕事が契約内容と合致していない。修正可能な

不具合があるかどうかも把握できておらず、深

刻な状態である。業者から提案される方法は効

果的とは言えない、またはその方法を実行されてもいない。

具合の復旧も迅速ではない。不具合の修正も全

く効果的ではなく、深刻な状態である。

(N) Not Applicable 該当なし No information or did not apply to your contract 評価材料がない、または該当せず。 Rating will be neither positive nor negative.

Contractor Information (Firm Name): ________________________________________________ Client Information (Name): ________________________________________________________

TO BE COMPLETED BY CLIENT

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

該当する評価基準に○を付けて下さい。

1. QUALITY:

a) Quality of technical data/report preparation efforts 技術データ／報告書作成作業の質

E VG S M U N

b) Ability to meet quality standards specified for technical performance サービスの品質は仕様書で要求されている技術基準に適合していた

E VG S M U N

c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance 詳細な助言無しで問題を適時/適正に解決ができる

E VG S M U N

d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance) 品質管理プログラムは適切かつ有効で、その品質管理プログラムに基づいて品質管理が実施されている（仕事に悪影響が出ることなく）

E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below) 契約に含まれてる納期・期限の遵守（遅延損害金の発生、または納期・期限が遵守されていなかった場合、詳しくお書き下さい）

E VG S M U N

b) Rate the contractor’s use of available resources to accomplish tasks identified in the contract 契約を遂行するための業者の資材調達、活用能力

E VG S M U N

3. CUSTOMER SATISFACTION:

a) To what extent were the end users satisfied with the project?

顧客満足度

E VG S M U N

b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports, businesslike and communication) 業者は御社の担当者との対応において協力的であった（意見の相違、論争をうまく解決する能力、ビジネスライクな対応、コミュニケーションを含む）

E VG S M U N

c) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer?

業者の協力姿勢、ビジネスライクな態度、顧客の希望を考慮したかど うかについての満足度

E VG S M U N

d) Overall customer satisfaction 総合的な顧客満足度

E VG S M U N

4. MANAGEMENT/ PERSONNEL/LABOR

a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force?

現場と人員の管理、下請け業者、取引業者、メーカー等との連携能力

E VG S M U N

b) Ability to hire, apply, and retain a qualified workforce to this effort 適格な労働力を雇用し、適用し、維持する能力

E VG S M U N

c) Government Property Control 政府の所有物の管理をする能力

E VG S M U N

d) Knowledge/expertise demonstrated by contractor personnel 請負業者の担当者の知識レベル

E VG S M U N

e) Utilization of Small Business concerns (Not applicable to contracts performed in Japan) 小規模事業者の活用度（日本国内で実施される契約には適用されない）

E VG S M U N

f) Ability to simultaneously manage multiple projects with multiple disciplines 複数の現場を同時に管理する能力

E VG S M U N

g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes 変更に対しての、優先順位の把握、計画、遂行の対応能力

E VG S M U N

h) Effectiveness of overall management (including ability to effectively lead, manage and control the program) 経営全般の有効性（プログラムを効果的に指導、管理、統制する能力を含む）

E VG S M U N

5. COST/FINANCIAL MANAGEMENT

a) Ability to meet the terms and conditions within the contractually agreed price(s)?

契約上の合意価格内で条件を満たす能力

E VG S M U N

b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client 請負業者が、コスト削減、保守性の向上、または顧客に利益をもたらすその他の要因をもたらす革新的な代替方法／プロセスを提案した。

E VG S M U N

c) If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns) この契約が政府コスト・タイプの契約である／あった場合、請負業者が適切な裏付け資料とともに月次請求書、月次状況報告書／予算差異報告書を提出する際の適時性及び正確性、確立された予算の遵守、並びに大幅な差異及び／又は説明のつかない差異の回避について評価してください。

E VG S M U N

d) Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section.

請負業者の会計システムは、コストの管理と追跡のために適切ですか？ 適切でない場合は、備考欄にその旨を詳しくお書きください。 Yes No

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

この契約が政府との契約である／あった場合、この契約の一部または全部が請負業者の責任で解約された又は、解約手続き中のものはありますか？ 不履行理由通知または是正措置通知が発行された場合、または不履行があった場合は、以下の備考欄に詳しくお書きください。 Yes No

f) Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

請負業者に財務上の問題があったという指摘はあるか？ Yes No

6. SAFETY/SECURITY

a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

請負業者はどの程度まで安全環境を維持し、承認された安全計画を遵守し、安全上の問題に対応できたか？(ハウスキーピング、安全性、指摘された欠陥の是正などに関する利用者の規則、規制、要件に従うことを含む）。

E VG S M U N

b) Contractor complied with all security requirements for the project and personnel security requirements.

請負業者は、プロジェクトのすべてのセキュリティ要件と要員のセキュリティ要件を遵守した。

E VG S M U N

7. GENERAL

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

緊急時の仕事又は仕事量の急増に対応する能力（政府の担当各所への適切なタイミングでの連絡を含む）

E VG S M U N

b) Compliance with contractual terms/provisions (explain if specific issues) 総合的な契約内容の遵守（具体的な問題があれば詳しくお書き下さい）

E VG S M U N

c) Would you hire or work with this firm again? (If no, please explain below) またこの会社に依頼したいですか？（そうでない場合、詳しくお書き 下さい） Yes No

d) In summary, provide an overall rating for the work performed by this contractor.

この請負業者が行った仕事に対する総合的な評価

E VG S M U N

Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):

上記の設問にお答えになり、下記に文章にて業者の長所、短所、欠点など、業者の選定に役立つコメントがあればお書き下さい。

Rev. Apr 2017 9