A3__PPQ.doc

PAST PERFORMANCE QUESTIONNAIRE

WHEN FILLED IN THIS DOCUMENT IS

SOURCE SELECTION SENSITIVE INFORMATION

SEE FAR 2.101 AND FAR 3.104

INSTRUCTIONS FOR OFFEROR

1. Offerors will complete Section A of the questionnaire (Pages 2 &3) for each reference and include with their proposal. The offeror will submit Section B of the questionnaire directly to their references and request the reference return the questionnaire directly to the Contract Specialist identified below. Offeror will complete Block 2 of Section B (Contract number and Program Name) before submitting to their references.

PROPOSAL RESPONSE DATE:

3 PM (ET) 21 September 2015

CONTRACT SPECIALIST

NAME:

MEGHAN THOMAS

TEL:

(315) 330-2177

MAIL:

AFRL/RIKO

ATTN: MEGHAN THOMAS

26 ELECTRONIC PKWY

ROME NY 13441-4514

SECTION A:

Offerors will complete Section A of the questionnaire (Pages 2 & 3) for each reference and include with their proposal.

1.

COMPANY NAME/ REFERENCE NAME:

ADDRESS:

TEL:

FAX:

EMAIL:

2.

CONTRACT #:

_______________________PROGRAM NAME:____________________________

3.

CONTRACTING OFFICER (IF DIFFERENT FROM REFERENCE): ________________________

4.

CONTRACT TYPE:

Firm-Fixed Price

Cost-Reimbursement Other (describe)

5.

DESCRIPTION OF WORK:

6.

BRIEF DESCRIPTION OF THE EFFORT Prime ____ or Subcontractor ____ 7.

AWARD DATE: _______________

SCHEDULED COMPLETION: ___________________

CURRENT / FINAL COMPLETION DATE (if different):

8.

AMOUNT PER YEAR: ___________________ CONTRACT TOTAL AMOUNT: ____________________

CURRENT / FINAL AMOUNT (if different): _________________________________________________

9.

COMMENTS REGARDING COMPLIANCE WITH CONTRACT TERMS AND CONDITIONS

10.

COMMENTS REGARDING ANY KNOWN PERFORMANCE DEEMED UNACCEPTABLE TO THE

CUSTOMER, OR NOT IN ACCORDANCE WITH THE CONTRACT TERMS AND CONDITIONS

11.

LIST ALL MAJOR SUBCONTRACTORS THAT WORKED ON REFERENCED PROJECT, IN WHAT TRADE, AND WHAT PERCENTAGE OF WORK DONE: ___________________________________________________________________________________

Past Performance Questionnaire SECTION B: Past performance reference completes this entire Past Performance Questionnaire section.

INSTRUCTIONS FOR REFERENCE

You have been identified as a past performance reference for solicitation FA8751-15-R-0006 Enclose Hangar Door- Electronic Research Facility Building 101 at the Air Force Research Laboratory, Rome NY. In order for the Government to evaluate the past performance of the Offeror identifying you as a reference, please complete Section B of this Past Performance Questionnaire, then return it to the Contract Specialist below. The Contract Number and Program Name provided by the Offeror are found in Block #2 below. If the Offeror performed additional contracts for your organization, please provide past performance information on those contracts as well.

RESPONSE DATE:

3 PM (ET) 21 September 2015

MEGHAN THOMAS, CONTRACT SPECIALIST

AFRL/RIKO

26 ELECTRONIC PKWY

ROME NY 13441-4514

TEL:

(315) 330-2177 or DSN 587-2177

FAX:

(315) 330-7315

E-MAIL:

Meghan.Thomas.1@us.af.mil The individual knowledgeable of the contractor’s day-to-day operations and overall performance should complete this questionnaire. However, that individual is encouraged to supplement their own knowledge of the contractor’s performance with the judgment of others within their organization, as applicable. Thank you for your assistance.

1.

NAME:

POSITION:

2.

CONTRACT #:

_______________________PROGRAM NAME:___________________________

3.

RELATIONSHIP AND TIME INVOLVED WITH OFFEROR:

4.

WHAT, IF ANY, ELEMENTS OF WORK WERE SUBCONTRACTED? PLEASE ESTIMATE

THE PERCENTAGE OF THE TOTAL WORK THAT WAS SUBCONTRACTED?

SECTION B, CONTINUED: Please rate the offeror’s performance using the scale below.

Performance meets contractual requirements and exceeds many to the Government’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 and exceeds some to the Government’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 were 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.

Performance 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.

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

EVALUATION AREAS

I. Quality E VG S M U N

Comments:

II. Timely Performance E VG S M U N

Comments:

III. Management Effectiveness E VG S M U N

Comments:

IV. Contract Administration E VG S M U N

Comments:

V. Compliance with Safety Standards E VG S M U N

Comments:

VI. Overall Performance E VG S M U N

ADDITIONAL COMMENTS (attach additional sheets as necessary):

FA8751-15-R-0006 Attachment 3