PPQ.pdf

DEPARTMENT OF THE ARMY

ENGINEER RESEARCH AND DEVELOPMENT CENTER, CORPS OF ENGINEERS

WATERWAYS EXPERIMENT STATION, 3909 HALLS FERRY ROAD

VICKSBURG, MISSISSIPPI 39180-6199

13 JUNE 2016

CEERD-CTV

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) Number W912HZ-16-R-0019

Dear Sir/Ma’am;

The US Army Engineer Research and Development Center (ERDC) is currently conducting a competitive source selection to evaluate offerors on subject RFP. As part of this evaluation, we have requested that the offerors provide information about their past performance on same or similar federal, state or local government or commercial contracts as compared to North American Industry Classification System (NAICS) 811219. You have been identified as the point of contact cited on the enclosure.

Your assessment of their performance is extremely valuable to our evaluation.

Please complete the enclosure and return to ERDC, ATTN: Amanda Andrews, 3909 Halls Ferry Road, Vicksburg, MS 39180-6199 or electronically to Amanda.Andrews@usace.army.mil, no later than 10 days after receipt of request or June 21, 2016 whichever occurs first.

Your cooperation is greatly appreciated. Questions may be directed to Amanda Andrews at 601- 634-5249.

Sincerely, Chelsea Whitten Contracting Officer

FOR OFFICIAL USE ONLY

Source Selection Sensitive

PAST PERFORMANCE QUESTIONNAIRE FORM

Contractor:__________________________ Contract Number:______________________ Subcontract Number (if applicable):________________________________________________ POC:_______________________________ Title:________________________________ Agency, Phone Number & Email Address:___________________________________________

The following questions pertain to the contractor’s record of past (within the past three years) and current performance. The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible.

Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.

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

Good: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Acceptable: Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.

Marginal: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.

Unacceptable: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

PART I. (To be completed by the Offeror)

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

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

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

A. CONTRACT IDENTIFICATION

Name:

Title:

Date:

Telephone Number:

Email Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

Acceptable

Acceptable

Acceptable Marginal (Explanation must be provided in Comments field below)

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).

C. Timeliness of Performance for Services and Product Deliverables.

B. Effectiveness of Project Management (to include use and control of subcontractors).

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Acceptable

Are you aware of other relevant past efforts by this company?

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

Organization: Name:

Title:

Date:

Telephone Number:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contracting Officer identified in the cover letter.

Thank you for your assistance.

Signature Date

Typed or Printed Name

H. Respondent Identification. Please provide the following information:

G. Other Information Sources. Please provide the following information:

F. General Comments. Provide any other relevant performance information.

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest