PPQ_-_Services.docx

Contract Performance Customer Questionnaire

1. Please complete this questionnaire. 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 offeror. Completed questionnaires may be emailed to:

COMMANDER, NAVY INSTALLATIONS COMMAND

ATTN: CHRISTOPHER SAUNDERS

FACILITIES AND ACQUISITION BRANCH N944

716 SICARD STREET, BLDG 111 STE 1000

WASHINGTON, DC 20374

CHRISTOPHER.SAUNDERS@NAVY.MIL

(202)433-9158

2. Please complete:

Company/Contractor Requesting Reference

Agency/Company Name Providing Reference

Company/Contractor Name

Agency/Company Name

Point of Contact Name

Point of Contact Name

Phone #

POC E-mail / Phone #

E-mail address

Period of Performance

Fax Number

Supply/Service Provided

PAST PERFORMANCE RATING GUIDELINES

Summarize Contractor Performance in each of the rating areas. Assign each area a rating of Unsatisfactory, Poor, Fair, Good, or Excellent. 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.”

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

-Compliance w/contract requirements -Technical excellence -Within budget -Relationship of negotiated costs to actual Timeliness of Delivery -Met interim milestones -Reliable -Delivery Schedule achieved Overall Customer Satisfaction -Effective Mgmt -Businesslike correspondence -Responsive to contract reqmnts -Prompt notification of problems -Reasonable/cooperative -Flexible -Pro-active

are comprising the achievement of contract reqmnts

require major agency resources to ensure achievement of contract reqmnts

do not impact achievement of contract reqmnts

PAST PERFORMANCE QUESTIONNAIRE

5. Agency/Company Completing Reference:

6. Agency/Company POC, Phone & Fax:

7. Period of Performance:

8. Overall Contract Value: $

9. Title of Contract:

10. Description of Contract Service: Develop and deliver fitness education

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

NOTE: Please use adjectival ratings from attached sheet.

a. Quality of Service

b. Timeliness of Delivery

c. Overall Customer Satisfaction

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

16. Name & Date:

17. Title:

Navy Fitness Program Manager