FA520517R0004_Atch5_PPQ.pdf

PAST/PRESENT PERFORMANCE QUESTIONNAIRE (PPQ)

SOLICITATION NO.:FA520517R0004

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

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor:________________________________________________________________________

B. Contractor Cage Code: _________________________________

C. Contract number: ______________________________________

D. Contract type: ______________________________

E. Was this a competitive contract? Yes _____ No _____

F. Period of performance: _________________________________________________________

G. Initial contract cost: $____________________________

H. Current/final contract cost: $_______________________________

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

J. Description of service provided:

SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name: __________________________________________________________

B. Customer or agency description (if applicable): __________________________________________

Atch. 5 to RFP No. FA520517R0004 Dated 5 Apr 17

SECTION 3: EVALUATOR IDENTIFICATION

A. Evaluator's name: __________________________________________________________________

B. Evaluator's title: ___________________________________________________________________

C. Evaluator's phone/fax number: ________________________________________________________

Length of time (number of years/months) evaluator worked on subject contract: ____________________

SECTION 4: EVALUATION

Please indicate your satisfaction with the contractor’s performance by placing an “X” in the appropriate block using the scale provided to the right of each question. This scale is defined as follows:

CODE PERFORMANCE RATING

E EXCEPTIONAL - During the entire period, the contractor met and exceeded many of the requirements of the contract and consistently performed at a superior level.

Performance was accomplished with very few minor problems, and the contractor took immediate and effective corrective actions for those problems that did occur.

VG VERY GOOD - During the entire period, the contractor met and exceeded some of the requirements of the contract and consistently performed very well. Performance was accomplished with some minor problems, and the contractor took timely and effective corrective action for those problems that did occur.

S SATISFACTORY - During the entire period, the contractor met the requirements of the contract and consistently performed at an acceptable level. Performance was accomplished with some problems, and the contractor took effective corrective action for those problems that did occur.

M MARGINAL – During the entire period, the contractor did not always meet some of the requirements of the contract and intervention was required to continue performance.

There were instances where performance was at a less than acceptable level;

performance was accomplished with some problems and some corrective actions appear only marginally effective or were not fully implemented.

U UNSATISFACTORY – During the entire period, the contractor did not meet the requirements of the contract and performance was at an unacceptable level. There were a number of serious problems that required extensive oversight and involvement, and corrective actions were either ineffective or non-existent.

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

When responding to the questions listed below, please place “X” in rating box for the scale of (E) to (U) that accurately describes the contractor’s performance. If a question is not applicable, select “N/A”. If more space is needed, use the back of the questionnaire or attach additional pages. Handwritten response to this questionnaire are acceptable. However, if responses are handwritten, please print legibly.

Quality Control E VG S M U N/A

Q1. Workmanship and quality control.

Q2. Adequacy / Implementation of CQC plan.

Q3. Adequecy of materials.

Q4. Adequacy of submittals, including as-builts.

Q5. Identification / Correction of deficient work in timely manner.

Effectiveness of Management E VG S M U N/A

E1. Cooperation and responsiveness.

E2. Management of resources / Personnel.

E3. Coordination and control of subcontractors.

E4. Effectiveness of job-site supervision.

Timely Performance E VG S M U N/A

T1. Adequacy of initial progress schedule.

T2. Adherence to approved schedule.

T3. Resolution of Delays.

T4. Submission of required documentation.

Compliance with Labor/Safety Standards E VG S M U N/A

S1. Compliance with labor laws and regulations.

S2. Adequacy of Safety Plan.

S3. Implementation of Safety Plan.

Cost Performance E VG S M U N/A

C1. How accurately did the contractor forecast contract costs?

C2. How well did the contractor meet forecasted costs and perform within contract costs?

C3. How successfully did the contractor alert the Government of unforeseen costs before they occurred?

Overall Rating E VG S M U N/A

Based on the above, what is your overall assessment of the present/past performance for this contractor?

Please discuss each and every response for which you indicated E (Exceptional), M (Marginal) or U

(Unsatisfactory) in response to the questions above (use additional sheets, if necessary).

3. Government Contracts Only: Was this contract partially or completely terminated for default or convenience or are there any pending terminations?

Yes___ Default___ Convenience___ Pending Terminations___

No ___

If yes, please explain (e.g., inability to meet cost, performance, or delivery schedules).

SECTION 5: NARRATIVE SUMMARY

Would you have any reservations about soliciting this contractor in the future or having them perform one of your critical and demanding programs?

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

Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address: 35 CONS/LGCP

Attn: Ms Miyako Fujimoto

Bldg. 656, Misawa Air Base

Misawa-shi, Aomori-ken, Japan 033-0012

E-Mail to: miyako.fujimoto.jp@us.af.mil