ATTACHMENT_L-5_PPQ.docx

PART IV – REPRESENTATIONS AND INSTRUCTIONS

ATTACHMENT L-5 EXAMPLE PAST PERFORMANCE QUESTIONNAIRE (PPQ)

ATTACHMENT L-5

ENVIRONMENTAL SERVICES AND CONSTRUCTION

PACIFIC AIR FORCES

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

POSITION

Part I – To Be Confirmed/Corrected by Reference

EXAMPLE OF PAST PERFORMANCE INFORMATION SHEET

THE FOLLOWING IS A SAMPLE OF THE INFORMATION CONTAINED WITHIN THE PAST PERFORMANCE INFORMATION FORM. WHERE APPLICABLE, THE KEYSTROKE LIMITATIONS CONTAINED WITHIN THIS VERSION ARE PROVIDED HERE FOR PLANNING PURPOSES.

ENVIRONMENTAL SERVICES AND CONSTRUCTION

PACIFIC AIR FORCES (ESC-PACAF)

PRESENT/PAST PERFORMANCE INFORMATION

1. Project Name/Title:

2. Contract Number (include TO if applicable):

3. Contracting Agency or Customer:

4. Contract type: Please mark all that apply.

If the values are different, explain why: __________________________________________________________________________________________________________________________________________________________________________

If the schedule has changed, explain why: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. Select all stakeholders you interacted with under this project: (Check all that apply) |_| Regulators |_| Elected Officials |_| Government agencies |_| Citizens Groups |_| Foreign Governments |_| Other: ___________________________________________

8. Place of performance: Specify cities, states, country, and DoD installations if applicable: _________________________________________________________________________________

9. Team members: List separately all ESC-PACAF team members that worked on this project. Lump the rest into “all other…” Identify for each contractor listed if they were a Prime or a subcontractor on this effort.

All other contractors not part of the proposed team

10. Please provide a brief description of service provided under this project. Summarize the scope of the project submitted and clearly state the paragraph in Part B or Part C of the ESC-PACAF PWS to which the project relates. (Do not include paragraphs from Part A of the ESC-PACAF PWS). Describe the rationale supporting your assertion of relevance of the submitted project to the ESC-PACAF acquisition.

5000 KEYSTROKE LIMITATION

11. Management actions employed to overcome problems under this project: Describe management actions employed in overcoming problems and the effectiveness of those actions, in terms of improvements achieved or problems rectified. This may include a discussion of efforts accomplished by the Offeror, or applicable Teaming Member, to resolve problems encountered on prior projects as well as past efforts to identify and manage program risk. Address at least one example of a regulatory issue or risk, the steps taken to solve the problem and the results. Other examples may include a discussion of efforts accomplished by the Offeror, or applicable teaming member, to resolve problems encountered on prior projects (identified by contract and TO number) as well as past efforts to identify and manage program risk. For example, submit quality performance indicators or other management indicators that clearly demonstrate that an Offeror, or applicable teaming member, has addressed and overcome past problems.

3000 KEYSTROKE LIMITATION

Part II – To Be Completed by Reference Please provide your opinion on the contractor’s performance for the following statements by putting a check mark in the appropriate box using the following definitions:

EXCEPTIONAL - Performance meets contractual requirements and exceeds many requirements to the Government's benefit. The contractual performance of the element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

VERY GOOD - Performance meets contractual requirements and exceeds some requirements to the Government's benefit. The contractual performance of the element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

SATISFACTORY - Performance meets contractual requirements. The contractual performance of the element being assessed, contained some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

MARGINAL - Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions or the contract's proposed actions appear only marginally effective or were not fully implemented.

UNSATISFACTORY - Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element being assessed contains serious problem(s) for which the contractor's corrective actions appear or were ineffective.

NOT APPLICABLE - Unable to provide a score. Performance in this area not applicable to the effort assessed.

1. The contractor’s ability to provide sufficient personnel and resources in a timely manner for this effort was:

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| N/A

13. To the credit or fault of the contractor, this project:

15. What would you consider the greatest strengths of this contractor?

500 KEYSTROKE LIMITATION

16. What would you consider to be the greatest weaknesses of this contractor?

500 KEYSTROKE LIMITATION

19. Please provide any additional comments as you desire or see fit.

Thank you for your prompt response and assistance!

Please return this completed questionnaire via E-Mail to: tracy.harris.8@us.af.mil

Past Performance Questionnaire (PPQ) FA8903-16-R-0006 ATTACHMENT L-5 Page 1 of 6