14-R-0001-Atch4-PPQ.pdf

Source Selection Information -- See FAR 2.101 and 3.104

FA5613-14-R-0001

Attachment 4

CONTRACTOR’S NAME: CONTRACT NUMBER:

For Official Use Only

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

INSTRUCTIONS FOR COMPLETING PPQ

1. This Acquisition is for Family Housing Maintenance Services at the Kaiserslautern Military Community (KMC), comprising Landstuhl, Ramstein Air Base and Kaiserslautern-Vogelweh area, for a total of approximately 1,903 housing units and appurtenant housing support systems, such as garages, storage sheds, fences, grounds, landscaping, maintenance support buildings, utility lines, outdoor recreation areas and playgrounds.

2. As part of the source selection process, this questionnaire is provided to assist the 700th Contracting Squadron in the past performance evaluation of offerors pertaining to the competitive acquisition for Family Housing Maintenance Services throughout the KMC that will result in the award of a federal contract. Therefore, it is important that your information be as factual, accurate and as complete as possible to preclude the need for follow-up queries by the evaluators. In an effort to expedite receipt of the requested information, the Contracting Officer respectfully requests that you DO NOT MAIL hard copies. Instead, please e-mail the completed questionnaire(s) to Ms. Gabriele Binder, e-mail: gabriele.binder.de@us.af.mil and Mr. Andrew Feutz, e-mail: andrew.feutz@us.af.mil, no later than 10 Dec 2013, 1200 hours CET. Please complete the attached questionnaire using the following guidance.

3. Indicate, based on the adjectives below, the contractor’s performance on the identified program. Assessments should reflect only contractor liable performance.

E VG S M U N

Exceptional Very Good Satisfactory Marginal Unsatisfactory Neutral

Performance meets contractual requirements with many exceeded to your organization’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than a few minor problems for which corrective actions taken by the contractor were highly effective.

Performance meets contractual requirements with some exceeded to your organization’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with no more than some minor problems for which corrective actions taken by the contractor was effective.

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 were satisfactory.

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element 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.

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.

was not observed or not applicable to the current effort being reported against.

PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF E, VG, M or U.

mailto:gabriele.binder.de@us.af.mil mailto:andrew.feutz@us.af.mil

4. Include the contractor’s name and the contract number for which the past performance information applies on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective prime/sub-contractors, etc.

I. BUSINESS AND PROGRAM IDENTIFICATION

A. GENERAL INFORMATION:

Contractor’s Name: ____________________ Address:

Telephone Number: ____________________

Email Address: ____________________

Point of Contact: ____________________

Project Title or Brief Description of Work* _________________________________________________________

Contract Number*: Contract Amount:

Contract Period or Dates of Performance*:

Contractor performed as the Prime Contractor Sub-Contractor Key Personnel.

To be completed by the rater and returned directly to the contracting office.

* Note: If offeror holds or has held other contracts with your agency/organization in the last 5 years, please complete separate evaluation forms for those contracts as well.

B. RATER INFORMATION:

Primary Alternate

Name of Rater: _____________________ Name of Rater: _____________________

Title: _____________________ Title: _____________________

Address: _____________________ Address: _____________________

Telephone Number: _____________________ Telephone Number: _____________________

Email Address: _____________________ Email Address: _____________________

Note: Once the PPQ is complete, it is considered to be Source Selection Information.

II. PROGRAM RELEVANCY

To determine program relevancy, please indicate below the services the contractor has or is performing under this contract by marking the applicable box with X or √ or N/A.

Overall Number of Housing Units serviced: __________ (please specify)

Basic Services

1. Change of Occupany Maintenance (COM)

2. COM cleaning/Facility cleaning

3. Painting (interior, exterior

4. Surface prepartion

5. Wall or ceiling covering / Replace ceramic wall tile

6. ,Repair and paint exterior insulation/masonry)

7. Floor/Surface Maintenance (preparation/replacement of hard wood f loor, ceramic floor tile, poly vinyl chloride floor tile, laminate, granite, carpet, etc.)

8. Private area patio/driveways/garage/sidewalk masonry surface repair (replace tiles, stones, etc.)

9. Replace counter top

10. Relace vanity/vanity top

11. Replace bathtub/shower base

12. Private yard landscaping (reseeding lawn, replacing sod lawn, applying mulch)

13. Exterior grounds maintenance

14. Grounds snow and ice removal

15. Fire damage clean up

16. Abandoned trash removal

Direct Scheduled Work/Recurring Work

1. Performance of routine, urgent and emergency service calls

2. Locksmith, key duplication work

3. Roof inspection

4. Gutter and downspout inspection and cleaning

5. Fence inspection

6. Lightning protection systems

7. Electrical dryer and duct cleaning

8. Mechanical rooms, electrical, equipment rooms, cable TV, fire protection system rooms, heat substations rooms or buildings (rooms)

Utility Maintenance Program

1. Plumbing systems (water, sewer, storm/rainwater systems)

2. Heating, ventilation and air conditioning systems

3. Electrical systems

4. Underground repair

Outdoor Recreation Area (ORA) Maintenance

1. ORA annual playground audit

2. Maintenance of ORA

3. Maintenance of playground equipment

Fire Protection Systems (FPS) Maintenance

1. Fire alarm systems

2. Fire sprinkler systems

3. Fire extinguishers

4. Radio transmitters

5. Smoke detectors

Appliance Services (repair, replacement, purchase)

1. Refrigerators, free-standing and built-in

2. Washers and Dryers

3. Stoves

4. Appliance repair parts

Self Help Store Operation

1. Self help store operations

Contractor Enviromental Requirements / HAZMAT

1. Hazardous waste removal (household quantities, tires, batteries, etc.)

2. Waste handling / Material recycling

3. Conformance with environmental requirements

Warranty Plan

1. Warranty tracking program

2. Suspected Warranty Reporting

Administrative Requirements

1. Excavation, Digging and Welding

2. General Officer Quarters, Senior Officer Quarters, Surplus and Non-Srplus Housing Tracking Report

3. Government property inventory

4. Maintenance of facility management files

5. Contractor quality control

6. Submit reports and schedules

III. PAST PERFORMANCE EVALUATION

Please mark the appropriate column with “X” or “√” using the definitions matrix set forth in the instructions, and provide a narrative explanation for ratings of E, VG, M or U.

The contractor: E VG S M U N N/A

1. Provided a non-disruptive phase-in of operations and achieved 100% capability at time of contract start.

2. Performed COM and COM cleaning within established turnaround times.

3. Responded to/completed service calls (routine, emergency, urgent service calls) within the time sets forth in the contract.

4. Established and maintained an effective Recurring Work Program (RWP).

5. Accomplished tasks IAW established RWP Schedule.

6. Submitted accurate and complete reports and schedules in a timely manner.

7. Completed utilities as scheduled.

8. Performed ORA services as scheduled.

9. Performed maintenance of FPS IAW prescribed frequencies and schedules, and ensured systems are operational at all times.

10. Followed Government accepted Quality Control Plan.

11. Suggested alternative approaches to problems.

12. Identified problems as they occured

13. Complied with environmental requirements.

14. Provided adequate project supervision.

15. Was responsive to contract changes.

16. How would you rate the contractor’s overall performance.

17. Was the contractor ever issued a cure or show cause notice under the referenced contract?

If yes, explain outcome in “remarks.”

YES NO

18. For US Government contracts only: Is the contractor rated in CPARS? YES NO

19. Would you award another contract to this contractor?

If not, explain in “remarks.”

YES NO

Remarks: ____________________________________________________________________________________

RETURN COMPLETED QUESTIONNAIRES DIRECTLY TO THE CONTRACTING OFFICER (see POCs at paragraph 2)