FIRE_Past_Performance_Questionnaire.pdf

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104

PAST/PRESENT PERFORMANCE QUESTIONNAIRE (PPQ) FA4659-15-R-0016

(Fill all applicable fields)

SECTION 1: CONTRACT IDENTIFICATION

Subject Contractor Name and POC: __________________ Contractor Address: ______________________ Contractor performed as the: PRIME SUB KEY PERSONNEL.

Contract Title: ________________________________________________ Contract Number: _______________________________________ Contract Type(e.g., FFP, FPIF, CPIF, CPFF):__________________ Was this a competitive contract? Yes_ No______ Contract Start Date:_________ Contract End Date:

Date of Most Recent Service Provided:

Initial Contract Cost: $ Total Modification Increase/Decrease $ Current/Final Contract Cost: $ Total Amount Actually Spent on Contract: $ ________

Description of Contract and Services provided:

Reasons for differences between initial contract cost and final contract costs:

Description of Total Funds Expended:

SECTION 2: EVALUATOR IDENTIFICATION(Person filling out survey)

A. Evaluators Name (s):

B. Position (e.g., Program Manager, PCO/ACO):

C. Description of Evaluators Contract Involvement:

D. Length of time (number of years/months) evaluator worked on subject contract:____________ E. Phone Number(s): _____________ F. Email Address: _____________________ G. Other suggested points of contact: _________________________

SECTION 3: PERFORMANCE INFORMATION:

See the table below for guidance on how to fill out the following survey. Please fill out survey completely to include narratives with detail.

E G S M U N

Exceptional Good Satisfactory Marginal Unsatisfactory Neutral Performance meets/met contractual requirements with many exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets/met contractual requirements with some exceeded to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor were effective.

Performance meets/met contractual requirements.

The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor were satisfactory.

Performance does not meet/did not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contractor’s proposed actions appear only marginally effective or were not fully implemented.

Performance does not meet/did not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Performance was not observed or not applicable to the current effort being reported against.

Using the definitions matrix above, choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. Place an “X” in the appropriate column below:

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.

3. Delegated authority to project managers and supervisors commensurate with contract requirements.

4. Home office participated in solving significant local problems.

5. Followed approved quality control plan.

6. Provided effective quality control and/or inspection procedures to meet contract requirements.

7. Corrected deficiencies in timely manner and pursuant to their quality control procedures.

The contractor: E G S M U N

8. Provided timely resolution of contract discrepancies.

9. Identified problems as they occurred.

10. Suggested alternative approaches to problems.

11. Displayed initiative to solve problems.

12. Was responsive to contract changes.

13. Provided adequate project supervision.

14. Paid subcontractors/suppliers in a timely manner.

15. Provided accurate and complete line item cost proposals including all aspects of work required for each task.

16. Cooperated with personnel after award.

17. How would you rate the contractor's overall performance on this contract?

18. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes, explain outcome in “Narrative.”

YES/NO

19. Would you award another contract to this contractor? If not, explain in “Narrative.”

YES/NO

Narrative for Questions 1-19: *Please provide a narrative explanation for any ratings of (E) Exceptional, (M) Marginal, or (U) Unsatisfactory.*

20. Was this contract partially or completely terminated for default or convenience or is there any pending terminations? No /Yes (Default Convenience Pending Terminations ) If “Yes”, please explain (e.g., inability to meet cost, performance, or delivery schedules).

21. Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs (please explain if yes)?

22. Has the contractor provided the management, tools, supplies, equipment, and labor necessary to support the contract and has the contractor abided by Federal and State statutes and National Fire Protection Association in regards to safety, security and environmental regulations in the performance of all testing?

23. Was the contractor ever issued a cure or show cause notice under the referenced contract? If yes explain the circumstances.

24. Please provide any additional comments concerning this contractor’s performance, as desired.

The undersigned certifies to the best of their knowledge that the information contained herein is accurate and complete.

Evaluator’s Signature Date

Please return this completed questionnaire to:

SSgt Justin Baker EMAIL: justin.baker.19@us.af.mil

FAX No: 701-747-4215

Thank you for your prompt response and assistance!

mailto:justin.baker.19@us.af.mil