Past Performance Questionnaire.pdf

PAST PERFORMANCE QUESTIONNAIRE

SECTION A: Contractor Information (to be completed by the contractor for who past performance information is being collected, prior to forwarding to assessors).

Note: Do NOT send this PPQ to the rated contractor, document is to be forwarded to the Contracting Officer diana.grube@va.gov.

Solicitation Number 36C24924R0083 Project/Requirement Project 621-22-107, Modernize Building 108 Boiler Plant and

Systems Customer/Agency James H. Quillen VA Medical Center Mountain Home, Tennessee 37684

1. Prospective Government Contractor’s

Name and Address

2. Contractor Point of Contact:

3. Phone Number (with area code):

4. Assessor Contract Award Number:

5. Description of Services:

6. Contract Award Date: _________ Contract Amount: Initial ________ Final___________

7. Period of Performance:

8. ASSESSOR INFORMATION:

Assessor Name

Title

Phone Number/Email Address

9. Authorization is hereby granted to provide the information requested in this questionnaire to

NCO 9 Network Contracting Activity, Murfreesboro, Tennessee.

Signature

Name and Title of Authorizing Official Date

SECTION B: Assessors Information (to be completed by assessors).

RATING SCALE Definitions

Rating Description Exceptional Proposal meets requirements and indicates an exceptional approach and understanding of the requirements. Proposal has strengths and no weaknesses. Risk of unsuccessful performance is minimal.

Highly Acceptable

Proposal meets requirements and indicates a thorough approach and understanding of the requirements. Proposal contains strengths which outweigh any weaknesses. Risk of unsuccessful performance is low.

Acceptable Proposal meets requirements and indicates an adequate approach and understanding of the requirements. Strengths and weaknesses are offsetting or will have little or no impact on contract performance. Risk of unsuccessful performance is moderate.

Marginal Proposal does not clearly meet requirements and has not demonstrated an adequate approach and understanding of the requirements. The proposal has one or more weaknesses which are not offset by strengths. Risk of unsuccessful performance is high.

Unacceptable Proposal does not meet requirements and contains one or more deficiencies. Proposal is un-awardable.

The questions on the survey (see below) shall be rated in accordance with the definitions provided in the Rating Scale. Any unsatisfactory or marginal rating shall be supplemented with an explanation in the space provided.

Management Effectiveness

1. Rate the contractor's compliance with contractual requirements.

(i) Offeror provided experienced personnel with technical and administrative abilities to meet contract requirements.

(ii) Offeror provided appropriate system documentation

(iii) Offeror’s overall management effectiveness

EXCEPTIONAL__HIGHLY ACCEPTABLE__ACCEPTABLE__MARGINAL__UNACCEPTABLE__

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Quality of Service and Workmanship

2. Rate the contractor's compliance with contractual requirements.

(i) Offeror provided professional services

(ii) Offeror maintained the quality products/service

(iii) Offeror achieved throughput specifications

(iv) Offeror achieved accuracy specifications

(v) Offeror achieved integration specifications (if applicable)

(vi) Offeror’s overall quality of products/service

Timeliness/Adherence to Schedules

3. Delivery of service was within required time period specified by contract requirements.

(i) Offeror delivered items timely as identified in your contract

(ii) Offeror was proactive in keeping you informed of schedule conflicts if they were going to occur

(iii) Offeror responded to emergency requirements in a timely manner

(iv) Overall offeror timeliness

Training/Technical Support

4. Rate the contractor's ability to provide required training/provide adequate technical support.

(i) Offeror provided useful quality training

(ii) Offeror provided prompt technical support after delivery

(iii) Offeror’s overall quality of training/technical support

Customer Satisfaction

5. Rate the contractor's ability to satisfy Customer expectations. control cost and submit invoices.

Are invoices complete, accurate, and timely?

(i) Offeror maintained a professional working relationship

(ii) Offeror was reasonable and cooperative in resolving customer complaints

(iii) Offeror was flexible in responding to urgent requirements

(iv) Overall customer satisfaction

How would you feel about awarding another contract to this contractor?

__________ Would not hesitate to award another contract to this contractor.

__________ Would most likely award another contract to this contractor.

__________ Would think twice about awarding another contract to this contractor but would do so if no better alternative existed.

__________ Do not wish to award another contact to this contractor.

__________ Would not award another contract to this contractor.

PLEASE PROVIDE RATIONALE FOR ASSIGNED RATING:

Overall rating of contractor's performance (quality, schedule, business relations,) on contract being assessed.

EXCEPTIONAL HIGHLY

ACCEPTABLE

ACCEPTABLE MARGINAL UNACCEPTABLE

VII. General Comments:

ASSESSOR:

Identify your role in the contract award or administration and the period of your involvement.

ROLE

PERIOD OF INVOLVEMENT

Contract Specialist/Contracting Officer Technical Project Lead/Project Officer

OTHERS

(Signature) (Date)

(Typed or Printed Name) (Organization Name)

(Phone Number)