PPQ_FILLABLE STIPDQ_ATTACHMENT 1.pdf

Attachment 1

RFQ 693JJ324Q000067

Title: STIPDG Contracting Officer: Myla Wyatt

PAST PEFORMANCE QUESTIONNAIRE (PPQ)

(Email directly no later than 3:30PM ET 9/4/2024 to Myla.Wyatt@dot.gov and Cc.. Carolyn.Lethert@dot.gov and HCFA-32SRI@dot.gov)

1. NAME OF FIRM/AGENCY PROVIDING REFERENCE/FEEDBACK:

PROJECT NAME: CONTRACT NUMBER : ________________________

PERIOD OF PERFORMANCE: CONTRACT TYPE (if applicable):

CONTRACT AWARD DATE: CONTRACT COMPLETION DATE:

AWARDED VALUE: CURRENT CONTRACT DOLLAR VALUE:

2. NAME OF REFERENCE:

EMAIL: PHONE NUMBER:

ASSOCIATION WITH FIRM BEING RATED (including role):

CONTRACT OR ORDER NUMBER (if applicable):

3. ASSESS THE FOLLOWING AREAS:(Check the appropriate box for each assessment category)

Assessment Categories Outstanding Satisfactory Unsatisfactory Other

a. QUALITY OF PRODUCT OR SERVICE/TECHNICAL APPROACH (For example: Were the services comprehensive, complete, and feasible? (Met the needs, performed successfully, and accommodated changing requirements.)

b. TIMELINESS OF PERFORMANCE/SCHEDULE (For example: Was the Contractor successful in planning and proposing realistic schedules, monitoring performance, completing work on time, and implementing corrections/changes in a timely manner?)

c. COST CONTROL (For example: Was the Contractor successful in planning and proposing realistic costs, monitoring performance, operating at or below budget, and implementing corrections/changes in a cost-effective manner?)

d. BUSINESS RELATIONS (For example: Was the Contractor reasonable and cooperative at the corporate and program levels in response to changes in technical direction, correcting errors, poor performance, criticism/rejection of contract deliverables and other quality issues?)

e. COMMUNICATION (For example: Did the contractor work and communicate well with contracting officers, contracting officer’s technical representatives, end users, other contractors, subcontractors, and in-house staff?)

f. RELIABILITY AND EFFECTIVE USE OF RESOURCES (For example: Was the contractor able to obtain in a timely manner the amount and type of personnel resources required to support the project, effectively train personnel to perform the work required for the project, and maintain the required workforce throughout the term of the contract?)

g. CUSTOMER SUPPORT/SATISFACTION (For example: Was the Contractor committed to customer satisfaction?)

h. OVERALL PERFORMANCE

i. OTHER AREAS:

(1)

The assessment above is of the Contractor’s record of past (within the past three (3) years) and current performance. The following adjectival ratings shall be used in your response.

Outstanding: Performance meets contractual requirements and exceeds many requirements that benefit the Government. Performance was accomplished with few, if any, minor problems for which corrective actions taken by the Contractor were highly effective.

Satisfactory-Performance met contractual requirements. Performance was accomplished with some minor problems for which any required corrective actions taken by the Contractor were satisfactory.

Unsatisfactory- Performance was not successfully accomplished or fails to meet a minimum requirement;

Other: If the element is not applicable, indicate with “N/A.” If no data has been obtained or additional comments are provided, please note in this column.

mailto:Myla.Wyatt@dot.gov mailto:Carolyn.Lethert@dot.gov mailto:HCFA-32SRI@dot.gov

Attachment 1

RFQ 693JJ324Q000067

Title: STIPDG Contracting Officer: Myla Wyatt

4. ADDITIONAL COMMENTS: