HT9410-25-Q-2008-Past-Performance-Questionnaire.docx

DOCX document 33 KB Posted

Attached to
Ice Machine Service Maintenance Federal contract opportunity
Solicitation number
HT941025Q2008
Issued by
Defense Health Agency

About this file

This is a Past Performance Questionnaire (PPQ) template for solicitation HT9410-25-Q-2008, issued by the Defense Health Agency (DHA) Western Markets Contracting Division. The questionnaire must be completed and returned by December 13, 2024, either through the offeror or directly to the government via email.

The PPQ contains 19 evaluation criteria including relationship management, subcontractor coordination, staffing capabilities, quality of work, schedule adherence, cost control, safety compliance, and documentation submission. Ratings are on a scale from Exceptional (E) to Unacceptable (U), with no plus or minus modifiers permitted. The form requires detailed information about both the offeror and the specific contract being evaluated, including contract numbers, values, and performance periods. This template does not contain any specific contract performance information as it is blank and ready to be filled out by references.

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Attachment 2

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Defense Health Agency (DHA) Western Markets Contracting Division is considering the Offeror listed below for a U.S. Government contract. Your comments would be appreciated regarding this firm’s past performance. After completing this PPQ, you are highly encouraged to send it back to the Offeror to be submitted with their quote. However, you may return it directly to this office via email to jojie.n.urrete.civ@health.mil no later than 13 December 2024. Your prompt response is greatly appreciated. If the referenced project is a government project, you may forward a copy of the official performance evaluation in lieu of completing this form. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

Offeror Information

Name of Offeror Being Evaluated:

Address of Offeror Being Evaluated:

Project Information

Contract Number:

Delivery/Task Order Number:

Contract/Project Title:

Location:

Award Date:

Completion Date:

Contract Value:

Offeror Performed As:
|_| Prime Contractor |_| Sub-Contractor

Description of Work Performed:

Evaluator Information

Name of Evaluator:

Government Agency/Commercial Company:

Address:

Phone Number:

Email Address:

Position Held in Relation to this Project:

Rating: Please evaluate the past performance using only the following ratings without variation.

DO NOT RATE ON A “+” OR “-” SCALE. If a “+” or “-” is used, the rating without the “+” or “-” will be applied. If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.

“E”
Exceptional
Performance greatly exceeded the contract requirements.
“VG”
Very Good
Performance exceeded the contract requirements.
“S”
Satisfactory
Performance met the contract requirements.
“M”
Marginal
Performance met the minimum contract requirements, but some material aspects of the contractor’s performance were less than satisfactory.
“U”
Unacceptable
Performance was poor and/or did not satisfy contract requirements.
“NA”
Not Applicable
No information or did not apply to your contract.

Please rate and provide any supporting information/comments for the following:

1. The relationship between the Offeror and client’s/customer’s contract team:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

2. The Offeror’s management and coordination of subcontractors:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

3. Ability/actions to hire and retain a sufficient number of qualified employees for the performance of the contract work:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

4. Overall corporate management, integrity, reasonableness, and cooperative conduct:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

5. Quality of work:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

6. Quality control:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

7. Ability to meet the performance schedule:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

8. Ability/actions to improve schedule problems, if applicable:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

9. Ability to control costs and provide the required work at a reasonable total price:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

10. Compliance with labor standards, as applicable:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

11. Compliance with safety standards and/or number of safety related incidents, code compliance, as applicable:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

12. Ability to submit required documentation (work schedule, reports, data, etc.) in a timely manner:
|_| |_| |_| |_| |_| |_|

E VG S M U NA

13. Have any cure notices, show cause letters, letter of reprimand, suspension of payment, or termination been issued? If yes, please explain:
|_| |_|

Yes No

14. Was the contractor able to solve contract performance problems without extensive guidance from your procurement or technical personnel? If no, please explain:
|_| |_|

Yes No

15. Would you award another contract to the party being evaluated? If no, please explain:
|_| |_|

Yes No

16. Was the customer satisfied with the end product? If no, please explain:
|_| |_|

Yes No

17. Has the firm being evaluated been provided an opportunity to discuss or respond to any negative comments or performance ratings? If so, what were the results?
|_| |_| |_|

Yes No NA

18. Additional Remarks:

19. Overall rating for this firm:
|_| |_| |_| |_| |_|

E VG S M U

Signature of Evaluator Date

PLEASE NOTE: Contractors may be advised of adverse remarks and given the opportunity to respond in accordance with Federal Acquisition Regulation (FAR) requirements. However, in accordance with FAR 15.306(e)(4), the names of individuals providing reference information about an Offeror’s past performance shall not be disclosed.

Past Performance Questionnaire, Page 1 of 3 (Rev 11/2022)

File details come from the government source that posted it. Updated .