Attachment 6 - PPIF.pdf

SOURCE SELECTION SENSITIVE IA W FAR 3.104 WHEN FILLED IN

FA4528-26-Q-SP02

PAST AND PRESENT PERFORMANCE INFORMATION FORM {PPIF)

A. GENERAL INFORMATION:

Contractor's Name: _______ _ Telephone : __________ _ Address: __________ _ Fax Number: __________ _

Point of Contact:

Submitting Survey as Prime or Sub-Contractor (please circle one) If submitting as Sub-Contractor, Prime Contractors Name:. ___________ _ Address: ___________ Fax Number: __________ _

Point of Contact: ________ _

Project Title and Detailed Description of Work: ___________________ _

Contract Number Provided by Offeror: ________ Dollar Amount: __ _

Contract Period or Dates of Performance Provided by Offeror: _________ _

Contractor performed as the D Prime Contractor D Sub-Contractor D Key Personnel.

B. RESPONDENT INFORMATION:

Name and Title of Evaluator: ___________ _

Company Name: _______________ _

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SOURCE SELECTION SENSITIVE IAW FAR 3.104 WHEN FILLED IN

Address: ________ _ Telephone Number: ________ _ Fax Number:

Email Address: ________ _

C. SEND COMPLETED SURVEY FORM TO:

Sherry Platt EMAIL: sherry.platt.1@us.af.mil

DUTY PHONE: (701) 723-2139

D. PERFORMANCE INFORMATION: Choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor's performance or situation. PLEASE PROVIDE A

NARRATIVE EXPLANATION FOR ANY RATINGS OF Mor U.

E G s M u N

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets Performance meets Performance meets Performance does Performance does Performance was contractual contractual contractual not meet some not meet most not observed or requirements and requirements with requirements. The contractual contractual not applicable to exceeds many to some to the contractual requirements. The requirements and the current effort the Government's Government's performance of the contractual recovery is not being reported benefit. The benefit. The element or sub- performance of the likely in a timely against.

contractual contractual element contains element or sub- manner. The performance of the performance of the some minor element being contractual element or sub- element or sub- problems for which assessed reflects a performance of element being element being corrective actions serious problem for the element or assessed was assessed was taken by the which the sub-element accomplished with accomplished with contractor were contractor has not contains a serious few minor some minor satisfactory. yet identified problem(s) for problems for which problems for which corrective actions. which the corrective actions corrective actions The contractor's contractor's taken by the taken by the proposed actions corrective actions contractor was contractor was appear only appear or were highly effective. effective. marginally ineffective.

effective or were not fully implemented.

CONTRACTOR'S NAME: ______ CONTRACT NUMBER: _____ _

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an "X" in the appropriate column using the definitions matrix above.

The contractor: E G s M u N

1. Provided experienced managers and supervisors with the technical and administrative abilities needed to meet contract requirements.

2. Demonstrated ability to hire, maintain, and replace, if necessary, qualified personnel during the contract period.

I The contractor:

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