PPQ CL DL Apr11.doc

PAST PERFORMANCE QUESTIONANAIRE

SOLICITATION NUMBER – FA5613-11-R-0007

Inspection, Maintenance & Repair of Car Lifts & Dock Levelers

1. Please complete this questionnaire using the below codes. Handwritten responses are sufficient. If you need more space than that provided, please attach additional pages or write on the back. Responses will be treated as source selection sensitive information. Email or Fax the completed questionnaire to:

NAME:

Ms. Edith Hollins-Jones

OFFICE:

700TH CONTRACTING/LGCA

TELEPHONE:

011-49-631-536-6871

EMAIL:

edith.hollins-jones@ramstein.af.mil

COMMERCIAL FAX:

011-49-631-536--8508

2. Explanation of codes:

CODE

PERFORMANCE LEVEL

E EXCEPTIONAL – The contractor’s performance meets contract requirements and exceeds many requirements.

V VERY GOOD – The contractor’s performance meets contract requirements and exceeds some requirements.

S SATISFACTORY – No problems exist or only minor problems exist for which solutions are in hand.

M MARGINAL – Problems exist for which there is doubt whether the identified solution is adequate but the problem appears to be within the contractor’s ability to solve.

U UNSATISFACTORY – Serious problems exist which may be outside the contractor’s ability to solve. The contractor is in danger of not being able to satisfy contractual requirements and timely recovery is not likely.

N NOT APPLICABLE – No performance record identifiable.

PAST PERFORMANCE QUESTIONANAIRE

SOLICITATION NUMBER – FA5613-11-R-0007

Inspection, Maintenance & Repair of Car Lifts & Dock Levelers

Please complete the following identifying information and past performance assessment:

A. Contractor: _________________________________________________________________ B. Point of Contact (POC) name: __________________________________________________

Phone Number: _____________________________________________________________

Email address: ______________________________________________________________

C. Contract Number: ____________________________________________________________

D. Location: __________________________________________________________________

E. Annual Contract Value/Amount: ________________________________________________

F. Number of car lifts/dock levelers serviced: ____________________________________

G. Period of Performance: _______________________________________________________

(DD-MMM-YYYY to DD-MMM-YYYY)

H. Description of services performed: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Circle the appropriate letter for each item on the questionnaire and provide supporting narrative explanation for each evaluation area.

EVALUATION OF THE CONTRACTOR’S PERFORMANCE:

To what extent did the contractor……

(1) Adhere to responsiveness/timeliness relative to performance/service schedules?

V

S

M

U

N

PAST PERFORMANCE QUESTIONANAIRE

SOLICITATION NUMBER – FA5613-11-R-0007

Inspection, Maintenance & Repair of Car Lifts & Dock Levelers

(2) Submit required reports and documents in a timely manner?

S

M

U

N

(3) Were the contractor’s reports and documentation accurate and complete?

S

M

U

N

(4) Able to solve contract performance problems without extensive guidance from government counterparts?

S

M

U

N

(5) Display responsiveness/timeliness relative to settling of customer complaints?

S

M

U

N

(6) Respond positively and promptly to technical direction, contract change orders, etc.?

S

M

U

N

PAST PERFORMANCE QUESTIONANAIRE

SOLICITATION NUMBER – FA5613-11-R-0007

Inspection, Maintenance & Repair of Car Lifts & Dock Levelers

(7) Develop and maintain an effective Quality Control plan reducing re-performance of unacceptable services?

S

M

U

N

(8) Comply with Safety Standards?

S

M

U

N