Atch_06_Past_Performance_Questionnaire.pdf

Attachment 6, FA9301-19-R-A013 Page 1 of 8

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Solicitation Number: FA9301-19-R-A013

DATE:

SUBJECT: Request for Past Performance Evaluation

FROM: (Contractor information here)

TO:

You have been identified as a point of contact for a past and/or present performance evaluation of the firm listed above. This firm is currently being considered for a Wastewater Treatment Plants (WWTP) Operation and Maintenance services contract at Edwards AFB, CA.

Your prompt attention to this questionnaire will be greatly appreciated. If you have any questions concerning this request, I can be contacted at ________________________________.

Please submit the completed questionnaire to the Government Contract Specialist and

Contrating Officer identified on the attached questionnaire. Thank you.

Contractor Signature Block

Attachment:

Past Performance Questionnaire

Attachment 6, FA9301-19-R-A013 Page 2 of 8

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Solicitation Number: FA9301-19-R-A013

WHEN FILLED IN THIS DOCUMENT IS SOURCE SELECTION SENSITIVE INFORMATION IAW FAR 2.101 & 3.104

The Air Force Test Center, Directorate of Contracting (AFTC/PZIOB), Edwards AFB, CA is conducting a source selection for a Wastewater Treatment Plants (WWTP) Operation and Maintenance Services contract. You have been identified as a past performance reference by a potential offeror. The questionnaire information will be used in the evaluation of the Past Performance factor contained in the instructions to offerors of the solicitation. Completed questionnaires will become part of the official source selection records and protected in accordance with FAR 2.101 and 3.104. Please complete and return this questionnaire to the individuals below within five (5) business days. Do not send a copy of the completed questionnaire to the offeror being assessed. Handwritten responses are sufficient. You may be contacted by our office to review the results of the questionnaire.

Evaluator, please complete, date, and sign the following:

SECTION 1: CONTRACT IDENTIFICATION

A. Contractor: _________________________________________________________

B. Contractor CAGE Code/DUNS: _________________________________

C. Contract number: ______________________________________

D. Contract type (FFP, FPIF, CPIF, CPFF, etc.): ______________________________

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:

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SECTION 2: CUSTOMER OR AGENCY IDENTIFICATION

A. Customer or agency name: ______________________________________

B. Customer or agency description (if applicable): ________________________________________

C. Location of contract performance: ______________________________________

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

SECTION 3: EVALUATOR IDENTIFICATION

A. Name: __________________________________________________________________

B. Title: ___________________________________________________________________

C. Phone number: ___________________________________________________________

D. E-mail address: ___________________________________________________________

E. Length of time (number of years/months) evaluator worked on subject contract:

F. Are you aware of another POC that might be appropriate for completion of this questionnaire? If so, please provide any information you can.

G. General comments:

SECTION 4: EVALUATION

A. 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. In the event a question is not applicable to your contract, mark N. The scale is defined as follows:

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E G S M U N

How well did the contractor provide experienced managers and supervisors with the technical and administrative abilities needed to operate a Wastewater Treatment Plant (WWTP)?

How well did the contractor demonstrate the ability to hire, maintain, and replace, if necessary, qualified and licensed or certified personnel as required by federal, state, county, and local laws?

How well did the contractor’s corporate office delegate authority to project managers and supervisors to fully act on behalf of management?

How well did the contractor submit timely preventive maintenance and inspection (PMI) plans in accordance with (IAW) industry standards?

How well did the contractor follow the approved PMI plan throughout the contract?

How well did the contractor provide all records and reports as required by the contract, federal, state, county, and local regulations?

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How well did the contractor perform all required maintenance and corrective actions?

How well did the contractor provide effective quality control and/or inspection plans that met contract, federal, state, county, and local requirements?

How well did the contractor follow the approved Quality Control Plan?

How well did the contractor correct deficiencies in a timely manner and pursuant to their quality control procedures?

How well did the contractor provide timely resolution of contract discrepancies?

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

How well did the contractor perform wastewater treatment operations as required by contract, federal, state, county, and local requirements/regulations?

How well did the contractor properly respond to, notify appropriate authorities, and execute emergency procedures involving the actual or eminent discharge of influent or effluent water?

How responsive was the contractor to contract changes?

How well did the contractor foster a partnering or teaming environment with your firm or agency?

How effective was the contractor’s material management (including Government Furnished Property or Material)?

How adequate/effective were the contractor’s environmental safety procedures?

Did the contractor perform work in a safe manner in accordance with OSHA standards?

How well did the contractor manage quality/effectiveness of sub-

Attachment 6, FA9301-19-R-A013 Page 6 of 8 contracted efforts?

How well did the contractor pay subcontractors/suppliers in a timely manner?

How smoothly did the contractor transition resources and personnel?

Of what benefit to the customer were contractor proposed alternative methods/processes that reduced cost, improved maintainability, or other factors?

Would you award another contract to this contractor? If not, explain in “remarks” section.

YES/NO

If a Government contract, is the contractor rated in CPARS? YES/NO

Was your contract for the operation of a California Class III or equivalent

WWTP?

YES/NO

Was your contract for the operation of a California Class IV or equivalent (or higher) WWTP?

YES/NO

Was your contract for the operation of a Tertiary Treatment System? YES/NO

Was your contract for the operation of an Activated Sludge System? YES/NO

Did the contractor receive any Notice of Violations (NOVs) or otherwise violate any federal, state, or local wastewater treatment statutes? If so, how many and what kind? Explain in the remarks section.

YES/NO

B. Please provide a narrative explanation for performance deemed “Marginal” or “Unsatisfactory”. If more comment space is needed, please attach additional pages.

C. Government Contracts Only: Was this contract partially or completely terminated for default or convenience or are there any pending terminations?

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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.

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Evaluator’s Signature Date

Thank you for your prompt response and assistance!

Please return this completed questionnaire to:

Mailing Address:

AFTC/PZIOB

Attn: Denina Solomon/Wendell W. Brown Jr.

5 South Wolfe Avenue Edwards AFB, CA 93524

E-mail:

denina.solomon@us.af.mil wendell.brown.2@us.af.mil mailto:denina.solomon@us.af.mil mailto:wendell.brown.2@us.af.mil