Past_Performance_Questionnaire_6_oct_2011.pdf

Form PPQ-0 (9/30/11)

NAVFAC PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0) CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information:

Firm Name:

Address:

Phone Number:

Point of Contact: Contact Phone Number:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other (Explain)

Percent of project work performed:

If subcontractor, who was prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: Firm Fixed Price Cost Reimbursement Other (Please specify):

Title:

Location:

Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work High Med Routine How is the project relevant to project submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

CLIENT INFORMATION (Client to complete Blocks 5-8)

5. Client Information Name:

Title:

Phone Number:

Email Address:

6. Describe the client’s role in the project:

7. Date Questionnaire was completed:

8. Client’s Signature:

NOTE: THE CONTRACTOR MAY COLLECT AND RETAIN COMPLETED QUESTIONNAIRES FROM

CLIENTS FOR SUBMITTAL TO THE GOVERNMENT. AFTER COMPLETION OF THIS FORM, THIS

FORM MAY BE DUPLICATED BY THE CONTRACTOR. THE GOVERNMENT RESERVES THE RIGHT TO

VERIFY ANY AND ALL INFORMATION.

TO BE COMPLETED BY CLIENT

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

E (EXCELLENT) – Performance meets contractual requirements and exceeds the Client’s/Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

V (VERY GOOD) – Performance meets contractual requirements and exceeds some of the Client’s/Government’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

S (SATISFACTORY) – Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective action taken by the contractor appear or were satisfactory.

M (MARGINAL) –Performance does not meet some contractual requirements. The contractual performance of the element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

U (UNSATISFACTORY) – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

N (NOT APPLICABLE) – No information or did not apply to your contract

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. Quality

a. Quality of technical data/report preparation efforts E VG S M U N

b. Ability to meet quality standards specified for technical performance. E VG S M U N

c. Timeliness/effectiveness of contract problem resolution without extensive customer guidance E VG S M U N

d. Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements. E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE

a. Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below)

E VG S M U N

b. Rate the contractor’s use of available resources to accomplish tasks identified in the contract. E VG S M U N

3. CUSTOMER SATISFACTION

a. To what extent were the end users satisfied with the project? E VG S M U N

b. Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports, businesslike and communication).

E VG S M U N

c. To what extent were the end users satisfied with the project? E VG S M U N

d. Overall customer satisfaction. E VG S M U N

4. MANAGEMENT/PERSONNEL/LABOR

a. Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force?

E VG S M U N

b. Ability to hire/apply a qualified workforce to this effort. E VG S M U N

c. Government Property Control E VG S M U N

d. Knowledge/expertise demonstrated by contractor personnel E VG S M U N

e. Utilization of Small Business Concerns E VG S M U N

f. Ability to simultaneously manage multiple projects with multiple disciplines E VG S M U N

g. Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes

E VG S M U N

h. Effectiveness of overall management (including ability to effectively lead, manage and control the program). E VG S M U N

5. COST/FINANCIAL MANAGEMENT

a. Ability to meet the terms and conditions within the contractually agreed price (s)? E VG S M U N

b. Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client.

E VG S M U N

c. If this is/was a Government cost type contract, the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns)

E VG S M U N

d. Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section.

E VG S M U N

e. If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

E VG S M U N

f. Have there been any indications that the contractor has had any financial problems? If yes, please explain below. E VG S M U N

6. SAFETY/SECURITY

a. To what extent was the contractor able to maintain and environment of safety, adhere to its approved safety plan, and respond to safety issues? (includes: following the user rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

E VG S M U N

b. Contractor complied with all security requirements for the project and personnel security requirements. E VG S M U N

7. GENERAL

a. Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

E VG S M U N

b. Compliance with contractual terms/provisions (explain if specific issues) E VG S M U N

c. Would you hire or work with the firm again? (If no, please explain below). E VG S M U N

d. In summary, provide an overall rating for the work performed by this contractor.

Please provde responses to the questions above (if applicable) and/or additional remarks.

Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assit our office in evaluating performance risk (pls attach additional page if necessary):