Attachment-6_PPQ.pdf

CONTRACTOR NAME:________________________ SOLICITATION NUMBER: FA9301-15-R-0003

When Filled In This Document Is Source Selection Sensitive IAW FAR 2.101 and FAR 3.104

FA9301-15-R-0003

Attachment 6 20 Nov 2015

PAST AND PRESENT PERFORMANCE QUESTIONNAIRE

A. GENERAL INFORMATION: (Respondent, please correct any inaccurate information)

Contractor’s Name: _______________________ Telephone Number: ____________________

Address: _______________________________ Fax Number: _________________________

Point of Contact: _______________________________________________________________

Project Title and Brief Description of Work:__________________________________________

Contract Number Provided by Offeror: ____________________ Dollar Amount: ____________

Highest number of Task Orders performed concurrently:________________________________

Contract Period or Dates of Performance Provided by Offeror: ___________________________

Contractor performed as the Prime Contractor Subcontractor Mentor/Protégé

Job Disciplines Performed:

* Note: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

B. RESPONDENT INFORMATION:

Name of Respondent: _______________________________ Title: _______________________

Address: ______________________________________________________________________

Telephone Number: __________________ Email Address:______________________________

C. EMAIL COMPLETED SURVEY FORM TO:

Matthew M. Bawden Aimee L. Amador 661-277-4976 661-277-0049

AFTC/PZIOB AFTC/PZIOB

matthew.bawden.3@us.af.mil aimee.amador@us.af.mil

D. PERFORMANCE INFORMATION:

Respondent, choose the appropriate letter on the scale (E, G, S, M, U, and N) that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF M or U.

Rating (Code) Explanation Exceptional (E) Performance meets/met contractual requirements with many exceeded 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.

Good (G) Performance meets/met contractual requirements with some exceeded 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.

Satisfactory (S) Performance meets/met 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.

Marginal (M) Performance does not meet/did 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.

Unsatisfactory (U) Performance does not meet/did 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.

Neutral (N) Performance was not observed or not applicable to the current effort being reported against.

# Performance Area E G S M U N

1 Quality of overall workmanship 2 Timeliness of delivery 3 Effectiveness of the quality control plan 4 Adequacy of submittals 5 Handling of warranty calls 6 Quality of management 7 Job site cleanliness 8 Cooperation with Government personnel 9 Professional conduct 10 Subcontract management 11 Payroll processing 12 Compliance with Specifications and Regulations 13 Job site safety 14 Business ethics

Would you award another contract to this contractor? If no, please explain:

Explanation of negative responses above:

Additional Comments:

Thank you for your response. Please be sure to return complete form to the Contracting Agency and not to the contractor you are providing the reference for.

Name:__________________________________Contact Phone #:________________________

Respondent Signature:______________________________ Date Completed:_______________