Attachment 4 - PPI Questionnaire.doc

FA5575-08-R-0010

Attachment 4

PRESENT/PAST PERFORMANCE QUESTIONNAIRE

The contractor listed below has provided the following project as a reference for Present/Past performance. Please provide frank, concise comments regarding your assessment of the contractor’s performance regarding this project. In accordance with FAR 15.306(e)(4), the names of individuals providing reference information about an offeror’s present/past performance shall not be disclosed.

1. CONTRACT INFORMATION: The below listed contractor has identified they provided or are currently providing services for your company/agency.

a. Contractor (Company/Agency):

b. Contractor Address/Phone:

c. Prime contractor or subcontract:

d. Title of Program/Contract:

1) Contract Number:

2) Period of Performance:

3) Services Provided (explain in detail the type of services provided by the contractor):

e. Total Contract Amount:

2. RESPONDENT IDENTIFICATION: This information will be kept confidential in accordance with FAR 15.306(e)(4). You may be contacted for additional information pertaining to present/past performance of the contractor identified in section 1 above.

a. Company’s Name: ________________________________________

b. Name and Title: _________________________________________

c. Phone Number: _________________ FAX: ________________ E-mail Address: ___________________

d. Address: _________________________________________

e. Relationship to Project: ____________________________________

f. Length of Involvement in Project: ______________

g. Date Questionnaire Completed: ______________

3. PERFORMANCE INFORMATION: When responding to the descriptive statements, choose the rating that most accurately describes the contractor’s performance or situation. If the statement is not applicable, circle “NEUTRAL”. The ratings correspond with the following descriptive values.

RATING SCALE

(E)xceptional: Performance meets contractual requirements and exceeds many to the customer’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective

(V)ery (G)ood: Performance meets contractual requirements and exceeds some to the customer’s benefit. The contractual 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.

(S)atisfactory: Performance meets contractual requirements. The contractual performance of the element or sub-element being assessed contains some minor problems for which corrective actions taken by the contractor were satisfactory.

(N)eutral: Did not observe performance in this area.

(M)arginal: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element 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.

(U)nsatisfactory: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-elements being assessed reflects a serious problem for which corrective actions were not accomplished. The contractor did not take any corrective actions.

(Circle one rating and provide additional comments as necessary)

a. How efficient was the contractor in providing all required contract

E VG S N M U

correspondence (e.g., quality plan, schedules, reports)?

b. To what extent was the required contract correspondence

E VG S N M U

accurate and complete?

c. How effective were the contractor’s quality control and/or

E VG S N M U

inspection procedures?

d. How did the contractor maintain quality standards of material

E VG S N M U

and workmanship?

e. How did the contractor provide timely performance and

E VG S N M U

maintain established schedules?

f. How did the contractor retain experienced management and key

E VG S N M U

personnel with technical and administrative abilities to effectively meet contract requirements?

g. To what extent was the contractor able to solve contract performance

E VG S N M U

problems without extensive guidance from procurement or technical personnel?

h. How did the contractor effectively comply with safety standards

E VG S N M U

throughout the performance period?

i. How did the contractor substantiate pricing data for change

E VG S N M U

orders/modifications?

j. If a warranty issue arose, to what extent did the contractor provide

E VG S N M U

timely assistance?

k. Was the contract partially or completely terminated for default or convenience?

YES

NO

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

l. Were any complaints from employees or subcontractors received concerning

YES

NO

non-payment by the prime contractor? If yes, explain.

m. Would you hire (commercial) or make award to (Government) this

YES

NO

contractor again? If no, why?

n. Overall Rating:

E VG S N M U

o. Additional Comments/Remarks:

Your corporation is highly appreciated. Please directly fax or e-mail completed questionnaires to:

496 ABS/LGC

Attn: TSgt Chad Wallach Fax: DSN (314) 722-8054 Comm. (34) 95 584 8054 E-mail address: chad.wallach@moron.af.mil

PAGE

FOR OFFICIAL USE ONLY