Attachment_7_PPQ.pdf

FA5000-17-R-0007 JBER MACC

Attachment 7- Past Performance Questionnaire

When completed, this document is Source Selection Information IAW FAR 2.101 and 3.104.

For Official Use Only Page 1 of 4

Section 1: Contract Identif ication

A. Contractor (Company/Division):

B. Contractor Cage Code:

C. Contract Number:

D. Contract Type (e.g., FFP, FPIF, CPIF, CPFF, etc.):

E. Program Title:

F. Brief Program Description:

G. Program Phase (e.g., Engineering & Manufacturing Development (EMD)):

H. Period of Performance

1. Original Schedule:

Beginning Date _________ through ____________

2. Actual Schedule:

Beginning Date _________ through ____________

3. Reason for difference (if applicable):

I. Contract Dollar Value

1. Original maximum contract dollar value: $

2. Actual maximum contract dollar value: $

3. Reasons for difference between original and actual contract dollar value (if applicable):

J. Description of work performed:

K. Was this a competitively awarded contract? ☐ Yes ☐ No

L. Contractor’s Role: ☐ Prime Contractor ☐ Subcontractor ☐ Joint Venture

Note: If offeror holds or has held other contracts with your agency/organization in the last three (3) years, only submit information on this PPQ for the requested contract. If the contractor performed less than satisfactory on any other contract please provide a narrative on a separate document as to that contract as well.

http://farsite.hill.af.mil/vffara.htm

For Official Use Only Page 2 of 4

Section 2: Customer or Agency Identif ication

A. Customer or agency name:

B. Customer or agency description (if applicable):

C. Geographic description of work performed under this contract (i.e., local, nationwide, worldwide):

Section 3: Respondent Identif ication

A. Respondent’s name:

B. Respondent’s title:

C. Respondent’s phone/e-mail address:

D. Length of time (number of years/months) respondent worked on subject contract and description of responsibility/position/role:

E. Other suggested points of contact:

Section 4: Performance Information

In the table below, indicate your rating for the contractor’s performance by placing an “X” in the appropriate block to the right of each question. Provide supporting comments in space provided for any rating Satisfactory or less. Attach additional pages if more space is needed. The performance rating scale is defined as follows:

Code Performance Rating

E EXCEPTIONAL – Performance meets contractual requirements and exceeds many requirements.

The contractual performance being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

V VERY GOOD – Performance meets contractual requirements and exceeds some requirements. The contractual performance being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S SATISFACTORY – Performance meets contractual requirements. The contractual performance being assessed 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 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.

U UNSATISFACTORY – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance being assessed contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N/A NOT APPLICABLE – Unable to provide a rating. Contract did not include performance for this aspect, performance was not observed, or information was not available. Do not know.

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The Contractor: E V S M U N/A

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

SUPPORTING INFORMATION:

2. Provided effective quality control and/or inspection procedures and corrected deficiencies in timely manner to meet contract requirements.

3. Developed and met realistic progress schedules.

4. Was responsive to contract changes and/or timely resolution of warranty defects.

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

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

EXPLANATION:

☐ Yes

☐ No

7. Would you award another contract to this contractor? If not, explain.

☐ Yes

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EXPLANATION:

8. Were at least six (6) disciplines used to perform the work on this effort?

Please check which disciplines were utilized:

☐ Design ☐ Fire Protection ☐ Demolition ☐ Structural

☐ Electrical ☐ Roofing/insulation/Thermal & Moisture Control

☐ Hazmat/Asbestos/Abatement Removal

☐ Mechanical (HVAC Controls/Plumbing)

☐ Horizontal Construction Roads & Airfields

☐ Horizontal Construction Utilities

☐ Yes

Additional remarks:

Respondent’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address:

673d Contracting Squadron Attn: Robert Peters & Jonathan Roddy 10480 Sijan Ave. Suite 231

JBER, AK 99506-2500

FAX to: 907-552-7497

E-Mail to: jonathan.roddy@us.af.mil and robert.peters.11@us.af.mil (Preferred method) mailto:jonathan.roddy@us.af.mil mailto:robert.peters.11@us.af.mil