Atch_5_Past_Performance_Questionnaire.doc

SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104

ATTACHMENT # 5

PAST/PRESENT PERFORMANCE QUESTIONNAIRE (PPQ)

27 Jul 15 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): __________________________________________

C. Geographic description of services under this contract, i.e. local, nationwide, worldwide, other Commands:

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.

V 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.

T1 What is the contractor’s proficiency in knowledge of disability evaluation policy and practices of all Service Departments and the Veterans Administration?

T2 How facile was the contractor with assembling and analyzing large amounts of data, organizing this data and quickly determining and documenting relevant and/or missing data?

T3 What is the contractor’s track record in customer service and effective liaison with multiple Federal agencies, specifically in terms of records release and collection of data?

T4 What is the contractor’s technical proficiency with review and understanding of medical documentation as it is transformed into an administrative process; to include familiarity and use within context of protected health information requirements?

T5 What is the contractor’s proficiency with use, understanding and review of military personnel records?

T6 What is the contractor’s proficiency with creation, use and sharing of digital records, to include use of proprietary and COTS databases which store and/or provide access to such records?

T7 What is the contractor’s experience and proficiency with creation, use and interpretation of quality assessment and review, specifically in terms of assessing a process for consistency and accuracy against a standard?

T8 What is the contractor’s proficiency with creation, use and administration of shared data networks (e.g. Sharepoint© or similar)

T9. What is the contractor’s proficiency with office management to include rapid response to changing priorities within a distributed and/or remote workforce?

T10. What is the contractor’s proficiency with use, understanding and protection of Personally Identifiable Information in mass quantities?

P1. How effective was overall contract management (including ability to effectively lead, manage, control and deliver on-time)?

P2. How reasonable, efficient and cooperative was the contractor when dealing with program staff (including the ability to successfully resolve disagreements/disputes; work with remote/dispersed staff)?

P3. How timely and effectively did the contractor resolve contract problems without extensive customer guidance?

P4. How well did the contractor understand/comply with customer objectives, time standards and technical requirements?

P5. How successfully did the contractor respond to changing requirements and/or surge situations?

P6. How did the contractor manage quality/effectiveness of sub-contracted efforts?

E1. How effectively was the contractor able to hire/apply a qualified workforce to this effort?

E2. How effectively was the contractor able to retain a qualified workforce on this effort?

2. 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: 1500 West Perimeter Road, Suite 2720, Joint Base Andrews NAF, MD 20762

FAX to: 240-612-2173 E-Mail to: grover.w.henderson.civ@mail.mil and melissa.s.tamayo.civ@mail.mil

SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104