4 - PPQ _PAST_PERFORMANCE_QUESTIONNAIRE FA486125R0003.docx

FOR OFFICIAL USE ONLY

SOURCE SELECTION INFORMATION – SEE FAR 3.104

NELLIS FA4861125R0003 SABER

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

The contractor, which is named below, requires this PPQ to be completed for a proposal for a Solicitation. This solicitation is in support of Nellis AFB, Creech AFB and Nevada Test and Training Range. The solicitation in question is FA4861125R0003 for a Simplified Acquisition of Base Engineer Requirements (SABER) IDIQ.

Submission of this form is mandatory for the evaluation of Contractor past performance if CPARS are not available. No other form of past performance evaluation will be considered for evaluation.

A primary consideration in our selection process is the contractor’s history of performance of similar efforts. Please make every effort to be thorough in your answers/comments. Return the completed questionnaire to the referenced contractor:_________________ at_____________________________.

Please refer any questions to: Corrine Lemon at (702-652-6196) or (corrine.lemon@us.af.mil)

A. GENERAL INFORMATION OF CONTRACTOR (completed by Offeror) Contractor Name:_______________________________________________________________

CAGE:_______________________ UEI:____________________________________________

Telephone Number:_______________ Point of Contact:_________________________________ B. RESPONDENT INFORMATION (completed by evaluating Contracting Officer) Name:_______________________________________________________________________ Title:________________________________________________________________________ Organization:__________________________________________________________________ Address:_____________________________________________________________________ Telephone_______________________________ Email:_______________________________

C. CONTRACT INFORMATION

Contract Number:______________________________________________________________ Title: ______________________________________________________________________ Was this contract an Air Force SABER?___________________________________________ Was this contract a MACC or Design Build Contract?________________________________ Period of Performance:____________________ Dollar Amount of Contract:_______________

Description___________________________________________________________________

D. PERFORMANCE INFORMATION:

For the section below, please indicate your satisfaction with the contractor’s performance by highlighting in the appropriate block code using the scale provided to the right of each question. This scale is defined as follows:

SAT SATISFACTORY - Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the Contractor appear, or were, satisfactory.

M MARGINAL - Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the Contractor has not yet identified corrective actions. The Contractor's proposed actions appear only marginally effective or were not fully implemented.

UNS UNSATISFACTORY - Performance does 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.

Please use the above ratings to describe the contractor’s performance in the following areas:

1. Quality

ATTACHMENT 4- PAST PERFORMANCE

QUESTIONNAIRE FA486125R0003

2. Schedule

3. Management

I certify that I am a Contracting Officer or contract professional responsible for the subject contractor evaluation. All information provided is true and valid to the best of my knowledge.

Evaluator’s Signature Date