HSBP1013R0071-A0002 Att(4) Revised PPQ.pdf

ATTACHMENT 4:

AIRCRAFT PILOT TRAINING

PAST PERFORMANCE QUESTIONAIRRE

Supplier Name:

Point of Contact:

Telephone:

Date:

Business Category (check all that apply)

SM=Small _____ LG=Large _______

SDVO=Service Disabled Veteran Owned ______

VO = Veteran Owned ______

Questionnaire Instructions:

Section A: Provide your answers with either a Yes or No answer.

Section B: Indicate which training you are proposing for by placing an “X” in the coordinating box.

Section C: Provide at least three (3) past performance references for Aircraft Pilot Training you have performed or been a subcontract. Your references may be private individuals, businesses or Government entities.

Section A: FAA Requirements – Please circle Yes or No

Do you have a Part 141 – Certificate? Yes or No?

Do you have a Part 142 – Certificate? Yes or No?

Do you have Initial/transition/aircraft type rating FAA-FAR Part 61.63 Certification? Yes or No?

Please provide evidence.

Do you have Initial/transition/aircraft type rating FAA-FAR Part 61.153 Certification?Yes or No?

Please provide evidence.

Do you have Annual/ Refresher/Pilot-in-command (IAW) FAA-FAR Part 61.58 Certification?

Please provide evidence.

Yes or No?

Section B: Course List Please indicate which training you are proposing for by placing an “X” in the coordinating box.

Requirement Course(s) Annual Quota

Our Proposal will Address

AS-350 B2 INITIAL (SIMULATION) or CORE (DUAL) 7

AS-350 B2 RECURRENT (SIMULATION) or CORE (DUAL) 63

AS-350 B2 IPC OPTION; INSTRUMENT PROFICIENCY COURSE

(DUAL) 25

AS-350 B2 NVG OPTION; NIGHT VISION GOGGLES WITH EPs

(DUAL) 15

AS-350 B2 ADDITIONAL FLIGHT TIME 3

AS-350 B2 M&HDA OPTION; MOUNTAINOUS TERRAIN + HIGH

DENSITY ALTITUDE (DUAL) 50

AS-350 B3 INITIAL (SIMULATION) or CORE (DUAL) 10

AS-350 B3 RECURRENT (SIMULATION) or CORE (DUAL) 113

AS-350 B3 IPC OPTION; INSTRUMENT PROFICIENCY COURSE

(DUAL) 35

AS-350 B3 NVG OPTION; NIGHT VISION GOGGLES WITH EPs

(DUAL) 15

AS-350 ADDITIONAL FLIGHT TIME 3

AS-350 B3 M&HDA OPTION; MOUNTAINOUS TERRAIN + HIGH

DENSITY ALTITUDE (DUAL) 85

EC-120 INITIAL (SIMULATION) or CORE (DUAL) 1

EC-120 RECURRENT (SIMULATION) or CORE (DUAL) 4

EC-120 IPC OPTION; INSTRUMENT PROFICIENCY COURSE (DUAL) 2

EC-120 NVG OPTION; NIGHT VISION GOGGLES WITH EPs (DUAL) 2

EC-120 ADDITIONAL FLIGHT TIME 1

EC-120 M&HDA OPTION; MOUNTAINOUS TERRAIN + HIGH

DENSITY ALTITUDE (DUAL) 2

UH-1H INITIAL (SIMULATION) or CORE (DUAL) 7

UH-1H RECURRENT (SIMULATION) or CORE (DUAL) 27

UH-1H IPC OPTION; INSTRUMENT PROFICIENCY COURSE (DUAL) 10

UH-1H NVG OPTION; NIGHT VISION GOGGLES WITH EPs (DUAL) 10

UH-1H ADDITIONAL FLIGHT TIME 3

UH-1H M&HDA OPTION; MOUNTAINOUS TERRAIN + HIGH

DENSITY ALTITUDE (DUAL) 20

UH-1N INITIAL (SIMULATION) or CORE (DUAL) 3

UH-1N RECURRENT (SIMULATION) or CORE (DUAL) 13

UH-1N IPC OPTION; INSTRUMENT PROFICIENCY COURSE (DUAL) 5

Requirement Course(s) Annual Quota

Our Proposal will Address

UH-1N NVG OPTION; NIGHT VISION GOGGLES WITH EPs (DUAL) 5

UH-1N ADDITIONAL FLIGHT TIME 2

UH-1N M&HDA OPTION; MOUNTAINOUS TERRAIN + HIGH

DENSITY ALTITUDE (DUAL) 10

AW-139 INITIAL 2

AW-139 RECURRENT 5

AW-139 SECOND- IN-COMMAND (SIC) 2

AW-139 SIC TO PILOT- IN-COMMAND UPGRADE 2

AW-139 ADDITIONAL SIMULATION PERIOD 4

SIKORSKY S76B INITIAL 5

SIKORSKY S76B RECURRENT 10

SIKORSKY S76B ADDITIONAL SIMULATION PERIOD 4

UH-60 A / L INITIAL 7

UH-60 A / L RECURRENT 93

UH-60 A / L INSTRUCTOR PILOT COURSE (IPC) 4

UH-60 A / L MAINTENANCE CHECK PILOT (MCP) 4

UH-60 A / L ADDITIONAL SIMULATION PERIOD 4

UH-60 M INITIAL 2

UH-60 M RECURRENT 16

UH-60 M MAINTENANCE CHECK PILOT (MCP) 1

UH-60 M ADDITIONAL SIMULATION PERIOD 2

KA-200 INITIAL (ELECTRO-MECHANICAL) 5

KA-200 RECURRENT (ELECTRO-MECHANICAL) 40

KA-200 IPC Option: Instrument Proficiency Course (Dual) 40

KA-200 Reduced Vertical Separation Minima 5

KA-200 High Altitude Training 5

KA-200 ADDITIONAL SIMULATION PERIOD ELECTRO-

MECHANICAL 4

KA-200 PL21 INITIAL 4

KA-200 PL21 RECURRENT 10

KA-200 PL21 IPC Option: Instrument Proficiency Course (Dual) 10

KA-200 PL21 Reduced Vertical Separation Minima 4

KA-200 PL21 High Altitude Training 4

KA-200 PL21 ADDITIONAL SIMULATION PERIOD 4

Quota

Our Proposal will Address

KA-350 PL21 INITIAL 20

KA-350 PL21 RECURRENT 60

KA-350 PL21 SECOND- IN- COMMAND (SIC) 2

KA-350 PL21 SIC TO PILOT-IN-COMMAND UPGRADE 2

KA-350 PL21 IPC Option: Instrument Proficiency Course (Dual) 60

KA-350 PL21 Reduced Vertical Separation Minima 20

KA-350 PL21 High Altitude Training 20

KA-350 PL21 ADDITIONAL SIMULATION PERIOD 4

C-12C INITIAL 7

C-12C RECURRENT 40

C-12C IPC Option: Instrument Proficiency Course (Dual) 40

C-12C Reduced Vertical Separation Minima 7

C-12C High Altitude Training 7

C-12C ADDITIONAL SIMULATION PERIOD 4

C-550 INITIAL 6

C-550 RECURRENT 50

C-550 SECOND-IN-COMMAND (SIC) 2

C-550 SIC TO PILOT-IN-COMMAND UPGRADE 2

C-550 IPC Option: Instrument Proficiency Course (Dual) 50

C-550 Reduced Vertical Separation Minima 6

C-550 High Altitude Training 6

C-550 ADDITIONAL SIMULATION PERIOD 3

DHC-8 200 CORE INITIAL 6

DHC-8 200 CORE RECURRENT 50

DHC-8 200 SECOND IN COMMAND (SIC) 2

DHC-8 200 SIC TO PILOT-IN-COMMAND UPGRADE 2

DHC-8 200 IPC Option: Instrument Proficiency Course (Dual) 50

DHC-8 200 Reduced Vertical Separation Minima 6

DHC-8 200 High Altitude Training 6

DHC-8 200 ADDITIONAL SIMULATION PERIOD 4

DHC-8 300 CORE INITIAL 5

DHC-8 300 CORE RECURRENT 50

DHC-8 300 SECOND IN COMMAND (SIC) 2

DHC-8 300 SIC TO PILOT-IN-COMMAND UPGRADE 2

Quota

Our Proposal will Address

DHC-8 300 IPC Option: Instrument Proficiency Course (Dual) 50

DHC-8 300 Reduced Vertical Separation Minima 5

DHC-8 300 High Altitude Training 5

DHC-8 300 ADDITIONAL SIMULATION PERIOD 4

PC-12 (X) INITIAL 7

PC-12 (X) RECURRENT 20

PC-12 (X) IPC Option: Instrument Proficiency Course (Dual) 20

PC-12 (X) Reduced Vertical Separation Minima 7

PC-12 (X) High Altitude Training 7

PC-12 (X) ADDITIONAL SIMULATION PERIOD 4

RW COMMERCIAL 2

RW INSTRUMENT 2

RW FLIGHT INSTRUCTOR 2

RW FLIGHT INSTRUCTOR INSTRUMENT 2

FW COMMERCIAL 1

FW INSTRUMENT 1

FW SINGLE ENGINE LAND (SEL) 1

FW MULTIENGINE LAND (MEL) 1

FW FLIGHT INSTRUCTOR SINGLE ENGINE LAND (SEL) 2

FW FLIGHT INSTRUCTOR MULTIENGINE LAND (MEL) 2

FW FLIGHT INSTRUCTOR INSTRUMENT 2

Section C: Three (3) Past Performance References:

1) Company Name (if applicable):

POC Name:

Phone:

E-mail Address:

2) Company Name (if applicable):

3) Company Name (if applicable):