Past_Performance_Questionaire.pdf

Revised 7 December 2011 1

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY

PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0) CONTRACT I N FOR MATION (Contractor to complete Blocks 1-4) I . Con t ractor I nformation Fi r m Name: CAG E Code:

Address: DUNs N um ber:

P hone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: Prime Contractor Su b Contractor Joint Venture Other (Exp la in ) Percen t of project work performed:

I f subcon tractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

De l ivery Task Order N umber (if applicable):

Contract Type: Firm Fi xed Price Cost Reimbursement Other ( Please spec i fy):

Contract Title:

Con tract Location:

Award Date (m m/dd/yy):

Contract Completion Date ( mm/dd/yy):

Actua l Completion Date (mm/dd/yy):

Expl a in Differences:

Ori ginal Contract Price (Award Amount):

Fina l Contract Price (to include all modifications. ( if applicable):

Explai n Differences:

4. Project Desc ri pt ion:

Com plexi ty of Work High Med Routi ne How is this project relevant to project of subm ission? (Please provide details such as similar equipment. requirements.

conditions. etc.)

CLI ENT I NFORMATION (Client to complete Blocks 5-8)

5. Client Information Na me:

Ti tle:

Phone N umber:

Ema il Address:

6. Descri be t he client's role in the project:

7. Date Questionnaire was completed (m m/d d/yy):

8. Client's Sig nat u re:

Note: 633 CONS requests that the client completes this questionnaire and submits directly back to the contracting office. Please contact the 633 CONS POC for any questions. The Government reserves the right to verify any and all information on this for.

Revised 7 December 2011 2

(E) Except ional Performance meets contractual requirements and exceeds many to the Governmen t/Owner's benefit. The contractual performance of t he element or su b-elemen t being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was h ighly effective.

An Exceptional rating is appropriate when the Contractor successfully performed mu lt iple sign ificant even ts that were of benefit to the Government/Owner. A singular benefit.

however, could be of such magnitude that it alone const i t utes an Exceptional rating.

A lso, there should have been NO significant weaknesses identified.

(VG) Very Good Performance meets contract ual requirements and exceeds some to the Government's/Owner's benefit. The contractua l performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

A Very Good rating is appropriate when the Contractor successfu ll y performed a sign i fican t even t that was a benefit to the Government/Owner. There should have been no significant weaknesses identified.

(S) Satisfactory Performance meets m i nimum contractual requirements. T he contractual performance of the element or sub-element contains some minor problems for wh ich correcti ve act ions taken by t he contractor ap pear or were satistactory.

A Satisfactory rat ing is appropr i ate when there were only minor problems, or major problems that the contractor recovered from withou t i mpact t o the cont ract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ra t ings is that contractors will not be assessed a rating lower tha n Satisfactory solel y for not performing beyond the requirements of the contract.

(M) Marginal Performance does not meet some contractual requirements. The contractua l performance of the element or sub-element being assessed renects a serious problem for which the contractor has not yet ident i fied corrective act ions. The contractor's proposed actions appear onl y marginal l y effect i ve or were not fully implemented.

A Margina l is ap propriate when a significant event occurred that the contractor had troubl e overcoming which impacted the Government/Owner.

(U) U nsa tisfactory Performance does not meet most contractual req uirements and recovery is not likely i n a timely manner. T he contractua l performance of the element or sub-element contai ns serious problem(s) for which the contractor's corrective act ions appear or were i neffect ive.

An Unsatisfactory rating is appropr iate when multiple si gnifica nt events occurred that the contractor had trouble overcoming and which impacted the Government/Owner. A singular problem, however, coul d be of such serious magnitude that it alone const it utes an unsatisfactory rat ing.

(N) Not A pplica ble No information or did not apply to your contract Rati ng will be neither positive nor negative.

ADJECT IVE RAT I NGS AND DEFIN ITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR'S PERFORMANCE

RATING DEFINITIONS NOTE

Revised 7 December 2011 3

Con tractor Information (Firm Name):

Cl ient Information (Name):

TO BE COMPLETED BY CLIENT

Please circle the adjective rating which best reflects you evaluation of the contractor’s performance Quality:

Quality of technical data/report preparation efforts E VG S M U N Ability to meet quality standards specified for technical performance E VG S M U N Timeliness/effectiveness of contract problem resolution without extensive customer guidance

E VG S M U N

Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance)

E VG S M U N

Schedule/Timeliness of Performance:

Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If the schedule was not met, please address below)

E VG S M U N

Rate the contractor’s use of available resources to accomplish tasks identified in the contract

E VG S M U N

Customer Satisfaction:

To what extent were the end users satisfied with the project? E VG S M U N 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)

E VG S M U N

To what extent was the contractor cooperative, businesslike, and concerned with the interests of your customers?

E VG S M U N

Overall customer satisfaction E VG S M U N Management/Personnel/Labor Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and /or labor force?

E VG S M U N

Ability to hire, apply, and retain a qualified workforce for this effort E VG S M U N Government Property Control E VG S M U N Knowledge/expertise demonstrated by contractor personnel E VG S M U N Utilization of Small Business concerns E VG S M U N Ability to simultaneously manage multiple projects with multiple disciplines

E VG S M U N

Ability to assimilate and incorporate changes in requirements and/or priority, including planning, E VG S M U N

Effectiveness of overall management (including ability to effectively lead, manage and control the program)

E VG S M U N

Cost/Financial Management Ability to meet the terms and conditions within the contractually agreed price(s)?

E VG S M U N

Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client

E VG S M U N

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)

E VG S M U N

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

E VG S M U N

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.

E VG S M U N

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

E VG S M U N

Safety/Security 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

E VG S M U N

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Con tractor Information (Firm Name):

regarding housekeeping, safety, correction of noted deficiencies, etc.)

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

E VG S M U N

General 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).

E VG S M U N

Compliance with contractual terms/provisions (explain if specific issues) E VG S M U N Would you hire or work with this firm again? (if no, please explain below) E VG S M U N In summary, provide an overall rating for the work performed by this contractor

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 evaluation performance risk (please attach additional pages if necessary).

Grace Andriliunas Contracting Specialist – 633 CONS 74 Nealy Ave Langley AFB, VA 23665