PPQ-Services.docx

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Bulk Fitness Equipment
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HDQMWR-17-R-0024
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Past Performance Questionnaire

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Amendment_1_Q&A.pdf PDF
17-R-0024_Bulk_Fitness.pdf PDF

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Contract Past Performance Questionnaire

1. In order to exercise option year, the COR/POC is required to provide information concerning the contractors performance during the current year. Please complete this questionnaire to fulfill this need. Handwritten responses are sufficient. If you need more space than that provided, please attach additional pages or write on the back. Responses will be treated as source selection sensitive information and will be sent directly to the Contract Specialist. This information is not to be released to the contractor.

2. Explanation of codes:

PAST PERFORMANCE RATING GUIDELINES

Summarize Contractor Performance in each of the rating areas. Assign each area a rating of Excellent, Good, Fair, Poor, Unsatisfactory. Use the following instructions as guidance in making these evaluations. Note: There is no corresponding guidance for “Customer Satisfaction”. Please use the comments area on the preceding form to justify the rating given “Customer Satisfaction.”

EXCELLENT
There are no quality problems
There are no cost issues
There are no delays
Response is effective
GOOD
Nonconformances

do not impact achievement of contract reqmnts Cost issues do not impact achievement of contract reqmnts

Delays do not impact achievement of contract reqmnts
Response is usually effective
FAIR
Nonconformances require minor agency resources to ensure achievement of contract reqmnts
Cost issues require minor agency resources to ensure

achievement of contract reqmnts

Delays require minor agency resources to ensure achievement of contract reqmnts
Response is somewhat effective
POOR
Nonconformances

require major agency resources to ensure achievement of contract reqmnts

Cost issues require major agency resources to ensure achievement of contract reqmnts
Delays require major agency resources to ensure achievement of contract reqmnts
Response is marginally effective
UNSATISFACTORY
Nonconformances

are comprising the achievement of contract reqmnts

Cost issues are comprising performance
Delays are compromising achievement of contract reqmts
Response is not effective

*N/A NOT APPLICABLE - Unable to provide a score. Performance in this area not applicable to effort assessed.

PAST PERFORMANCE QUESTIONNAIRE

1. Contractor Name:
2. Contract Number:

3. Contractor Address:

4. Contract Type:

|_| Firm Fixed Price |_| Cost Reimbursement |_| Other (Please Specify)

5. Agency Name & Dept: CNIC

6. Agency POC/Phone/Fax:

7. Period of Performance:

8. Dollar Amount of Award: $ Total Dollar Value with Mods:

9. Title of Contract:

10. Description of Contract Service:

11. Complexity of Work: Difficult: |_| Routine: |_|

The following evaluation factors below can be changed to correlate with the type of contract:

12. Evaluation Factor
13. Comments (Attach additional sheets, if necessary.)
14. Rating

a. Quality of Work

b. Personnel

c. Subcontractor Mgmt

d. Business Relations

e. Timeliness of Performance

f. Customer Satisfaction

g. Cost/Budget Control

15. Would you select this firm again? Please explain. (Attach additional sheet if necessary.)

16. Name & Date:

17. Title:

NOTE: Please use adjectival ratings from attached sheet.

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

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