06_Army_Phase_2_PPQ_15Sep17.pdf

PAST PERFORMANCE RISK ASSESSMENT QUESTIONNAIRE (PPQ)

W912DY-17-R-0102 RFP – Army Phase 2 RMMR

RFP NO: W912DY-17-R-0102 Prime Offeror Name:

Cage Code:

SUBMISSION: __ OF 3 (Offeror may provide up to 3 submissions for each teammate)

DESCRIPTION: Fuels Recurring Maintenance and Minor/Emergency Repairs for Army Phase 2

NOTE: Offeror shall incorporate into the past performance section of the proposal, page one (1) of each PPQ sent to evaluators. In the event that an evaluator does not return a completed PPQ, the Government will call to verify information provided on page one. The government does not anticipate calling evaluators that have returned a completed PPQ.

Evaluator, Please provide your candid responses. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators.

PART I. (To be completed by the Offeror)

(1) Contractor Name:

(2) Contractor Address (Street, City and State):

(3) CAGE Code:

(4) Contract Number:

Type of Contract: ☐ “C” Contract, ☐ ID/IQ task order, ☐ GSA order, ☐ Other (Specify):Services

Type of Pricing Arrangement: ☐ Fixed Price ☐ Cost Reimbursement ☐ Other (Specify):

(5) Prime Contractor (if different from the contractor name cited above):

CAGE Code:

(6) Title of Project:

(7) Description of Work:

(8) Location of Work:

(9) Date of Award:

(10) Status: ☐ Active ☐ Complete, Completion Date:

(11) Name and telephone number of Technical Representative:

PART II. EVALUATION (To be completed by the technical representative identified on line 11 – If unavailable, to be completed by a technical representative knowledgeable of the contractor’s responsibilities and performance.

(1) Please evaluate the contractor's performance regarding compliance with the statement of work:

Excellent

Good

Satisfactory

Marginal

Unsatisfactory

Remarks: (Insert additional comments here)

(2) Please evaluate the contractor's performance regarding overall technical expertise demonstrated.

(3) COMPLIANCE WITH ADMINISTRATIVE CONTRACTUAL REQUIREMENTS

Please evaluate the contractor's performance regarding items such reporting, deliverables, etc.

If given the opportunity, would you work with this contractor again? ☐ Yes ☐ No ☐ Not Sure

OTHER REMARKS:

(1) Please use the space below to provide other information related to the contractor's performance.

PART III. RETURN INSTRUCTIONS

Please return this completed Questionnaire via e-mail to the following email addresses:

CEHNC-DLAFuelsPPQs@usace.army.mil

Thank you for your assistance.

mailto:CEHNC-DLAFuelsPPQs@usace.army.mil