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Past Performance Questionnaire (PPQ) Form The Offeror must complete Sections IIA and IIB for each Past Performance reference and send copies to the PPQ respondent(s) identified in IIA in a timely manner. The Offeror shall include these documents with its proposal; however, the PPQ respondent will send the completed questionnaire directly to the POC identified in the PPQ Section IV below.
In order to assess potential contractors Army Contracting Command – Rock Island (ACC-RI) is obtaining past performance information with respect to each Offeror. The PPQ respondent will complete all sections of the PPQ except sections IIA and IIB. In addition to this questionnaire, you may receive a follow-up phone call or email to confirm or clarify information. This is a critical acquisition being conducted by ACC-RI and your support is sincerely appreciated.
Thank you for your time, effort, and cooperation in responding to this questionnaire. The completed questionnaire shall be submitted directly via email to MichelleAnn Hulett, Contract Specialist, michelleann.g.hulett.civ@army.mil and Bethany Carbajal, Contracting Officer, bethany.n.carbajal.civ@army.mil .
The subject line in the submission email shall clearly indicate: ‘[Offeror Name] W519TC-23-R-107 message shall originate from the PPQ respondent’s Government or corporate email address.
SECTION I. GENERAL GUIDANCE
Please use the following rating in scoring the performance elements below (assessments should reflect only contractor-liable performance):
| Excellent |
| The Offeror’s past performance far exceeds the customer's expectations and provided significant, unusual worthwhile features or benefits. |
| Good |
| The Offeror’s past performance exceeds the customer's expectations and provided significant, unusual worthwhile features or benefits. |
| Satisfactory |
| The Offeror’s past performance met the customer's expectations and contract requirements. |
| Marginal |
| The Offeror’s past performance could have been improved. The Offeror required major agency resources to ensure achievement of contract requirements. |
| Unsatisfactory |
| The Offeror’s past performance did not meet customer expectations and/or contract requirements. |
SECTION II. GENERAL INFORMATION
| II-A | RESPONDENT IDENTIFICATION / POC |
| 1. |
| Name & Title: |
| II-B | CONTRACT IDENTIFICATION |
| 1. |
| Offeror: |
| 2. |
| DoD Entity (CAGE) Code of Evaluated Contractor: |
| 3. |
| Type of Instrument - Contract/Order/Subcontract/Other: |
| 4. |
| If Sub contract identify Prime Contractor: |
| 5. |
| Contract Identification Number: |
| 6. |
| Order Number (if applicable): |
| 7. |
| Project Title and Demil Description (add rows if needed, up to 200 words): |
| 8. |
| Pricing Type (e.g., Fixed Price, Time and Materials, Cost Reimbursable): |
| 10. |
| Date work effort/contract will end: |
| 11. |
| Initial Contract Dollar Value (w/Options): |
| 12. |
| Current/Final Contract Dollar Value (w/Options): |
| 13 |
| Period of Performance (including all options) |
| 14. |
| Place(s) of Performance: |
| 15. |
| Contracting Officer Contract information |
| 16. |
| Technical COR Contact Information |
| III-C | GENERAL INFORMATION |
| 1. |
| Respondent’s Role (e.g., COTR, Contracting Officer) for evaluated contract and length of time in role: |
| 2. |
| Has this contract been partially or completely terminated? If yes, explain and identify type of termination (e.g., default, convenience). |
| 3. |
| What were the production quantity requirements for this contract and did the contractor meet those requirements? |
| 4. |
| Were there any changes in contract dollar amounts throughout the life of the contract; and if so, please explain (e.g., Government or Contractor caused): |
| 5. |
| Were there any PQDRs/CARs/Compliance reports issued on this contract; and if so please explain how resolved. |
| 6 |
| Compliance with First Article Test Samples (if applicable)? |
III-D CONTRACT PERFORMANCE
Please Rate This Contractor With Respect To:
A. Meeting contract quality and delivery requirements including specifications, standards of good workmanship, and technical direction:
| Rating |
| Excellent |
| Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
Comment: ___________________________________________________________________ B. Contractor’s ability to deliver according to the agreed-to schedule. What were the causes of any schedule variances?
| Rating |
| Excellent |
| Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
C. Contractor’s ability to identify and correct problems and prevent or mitigate potential problems in a timely manner:
| Rating |
| Excellent |
| Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
D. Satisfaction level of work effort performed:
| Rating |
| Excellent |
| Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
E. Contractor’s compliance with security requirements OSHA:
| Rating |
| Excellent |
| Good |
| Satisfactory |
| Marginal |
| Unsatisfactory |
Check
IV. RETURN INFORMATION
When completed, please send electronically via email to: MichelleAnn Hulett, Contract Specialist, michelleann.g.hulett.civ@army.mil and Bethany Carbajal, Contracting Officer, bethany.n.carbajal.civ@army.mil .
Thank you for your assistance.
