ATTACHMENT_5_-_PPQ.doc

ATTACHMENT 5

SOLICITATION HTC711-16-R-R015

PAST PERFORMANCE QUESTIONNAIRE

When Filled In This Document Is Source Selection Sensitive

Information IAW FAR 2.101& 3.104

SECTION 1: CONTRACT IDENTIFICATION

INSTRUCTIONS: The Offeror submitting a response to USTRANSCOM Solicitation number HTC711-16-R-

R015 completes this section prior to sending to the Respondent.

A. Contractor Name: ___________________________________________________________________________

B. Contract Title/Number: ______________________________________________________________________

C. Brief Description of Work Performed (include workload estimates):

D. Location(s) where service was performed under this contract: _______________________________________

E. Contractor being evaluated performed as the: _____Prime or _____Subcontractor (Mark one)

F. Contract Type: _____Fixed Price _____Cost _____IDIQ _____Single Award _____Multiple Award

Other:____________________________________________________________________________________ G. Period of performance (month/year – month/year): ________________________________________________

H. Dollar Value (include per year cost and life cycle cost): ____________________________________________

SECTION 2: RESPONDENT INFORMATION

INSTRUCTIONS: The remaining sections are to be completed by Respondent.

The results of this survey will aid the Government in determining whether there is a reasonable expectation that the contractor will successfully perform the Naval Air Warfare Center Weapons Division (NAWCWD) Logistics Aircraft and Drone Recovery Services effort. Therefore, it is important the responses be candid, factual, and as complete as possible.

If you do not have knowledge of, or experience with, the contract referenced above, please forward this Questionnaire to the person who can provide the information. Also, if offeror holds or has held other relevant contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

Questionnaires must be returned no later than 17 June 2016, to USTRANSCOM Acquisition Office via E-mail: deborah.l.long26.civ@mail.mil and mary.p.chapie.civ@mail.mil. Please indicate “Performance Survey” in the subject. Note, this information is to be received directly from the respondent and will not be considered if received from the Offeror.

A. Respondent's name: __________________________________________________________________________

B. Respondent's title: ___________________________________________________________________________

C. Customer or agency name: ____________________________________________________________________

D. Respondent's phone number: ___________________________________________________________________

E. Respondent’s Email: _________________________________________________________________________

F. Description of Work Performed (include workload estimates). Note: If any of the information in Section 1 is incorrect, please provide the correct information here.

G. Was contract performance assessed in Contractor Performance Assessment Reporting System (CPARS)?

________ Yes ________ No

NOTE: The Past Performance Information Retrieval System (PPIRS) may be reviewed for the referenced contract as well as responses to this questionnaire. Although you may have filed a CPARS for the contract listed, we appreciate your response to this questionnaire because some of the questions relate to areas not covered by CPARS.

SECTION 3: PERFORMANCE INFORMATION

INSTRUCTIONS: Place a mark in the block that most accurately describes the contractor’s performance or situation.

In responding to the survey, please justify and explain Marginal or Unsatisfactory ratings. As the Respondent, you may be contacted to clarify comments or ratings. In order for the government to review and assess the contractor’s past performance rating, please use the following ratings to describe the offeror’s performance on your contract or project:

Exceptional (E) - Performance met all contract requirements and exceeded many to your company’s (or agency’s) benefit. Problems, if any, were negligible and were resolved in a timely, highly effective manner.

Very Good (VG) - Performance met all contract requirements and exceeded some to your company’s (agency’s) benefit. There were a few minor problems that the contractor resolved in a timely, effective manner.

Satisfactory (S) - Performance met contract requirements. There were some minor problems and corrective actions taken by the contractor were satisfactory.

Marginal (M) - Performance did not meet some contractual requirements. There were problems, some of a serious nature, for which corrective action was only marginally effective or was not fully implemented.

Unsatisfactory (US) - Performance did not meet most contractual requirements. There were serious problems and the contractor’s corrective actions were ineffective.

Unknown (U) - No record of past performance or the record is inconclusive.

Not Applicable (NA) – The requested information was not related to the referenced contract effort.

Rating Comments. Please discuss each response for which you indicated Marginal or Unsatisfactory performance in response to the questions above (use additional sheets, if necessary).

Survey Respondent’s Signature

Date

Thank you for your prompt response and assistance!