C4_Attachment_0003_-_Past_Performance_Questionnaire.pdf

Attachment 0003 – Past Performance Questionnaire

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 V below.

In order to assess potential contractors ACC-RI contracting office is obtaining past performance information with respect to each Offeror. The PPQ respondent will complete all sections of the Past Performance Evaluation Questionnaire 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, Bridget Kramer, Contract Specialist, Bridget.L.Kramer.civ@mail.mil

The subject line in the submission email shall clearly indicate: ‘[Offeror Name] W52P1J- 18-R-0068 Demil and Disposal of Propelling Charges PPQ’. The message shall originate from the PPQ respondent’s U.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):

RATING DESCRIPTION

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.

GENERAL INFORMATION

SECTION IIA RESPONDENT IDENTIFICATION / POC

1. Name & Title:

2. Organization:

3. Address:

4. Phone No:

5. E-mail:

6. Date:

SECTION IIB 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):

9. Date of Award:

10. Date work effort/contract will end:

11.

Initial Contract Dollar Value (w/Options):

12.

Current/Final Contract Dollar Value (w/Options):

Period of Performance (including all options)

14. Place(s) of Performance:

SECTION III GENERAL INFORMATION

1.

Respondent’s Role (e.g., COR, 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.

If this was an award or incentive fee contract, what percentage of the available fee did the Contractor receive (if applicable, breakout by performance period)?

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 driven):

Section IV CONTRACT PERFORMANCE

Please Rate This Contractor With Respect To:

A. Conforming to the contract requirements including Statement of Work (SOW)/

Performance Work Statement (PWS), specifications, standards of good workmanship, and technical direction:

Rating Excellent Good Satisfactory Marginal Unsatisfactory Check

Comment:

B. Adherence to the contract schedule?

C. Contractor’s ability to identify and correct problems and prevent or mitigate potential problems in a timely manner:

D. Satisfaction level of work effort performed:

E. Has the contractor demonstrated reasonable and cooperative behavior in dealing with your staff and other contractors (including responsiveness and the ability to successfully resolve disagreements/disputes):

F. Contractor’s compliance with security requirements OSHA and EPA:

G. Contractor’s ability to effectively manage subcontractors and/or team members

(this includes payment, billing and invoicing of subcontractors):

H. Contractor’s ability to meet appropriate staffing levels with technically qualified personnel to provide required services (i.e., to hire/retain qualified personnel, to provide continuous training to maintain critical skills, and to replace personnel):

Are you aware of other Demil efforts by this company where problems have occurred?

If yes, please provide the name and telephone number of a point of contact:

SECTION V RETURN INFORMATION

When completed, please send electronically via email to: Bridget Kramer, Contract Specialist, Bridget.L.Kramer.civ@mail.mil. The subject line in the submission email shall clearly indicate: ‘[Offeror Name] W52P1J-18-R-0068 Demil and Disposal of Propelling Charges PPQ’. The message shall originate from the PPQ respondent’s U.S.

Government or corporate email address.