Enclosure_4_Past_Performance_Questionnaire_(PPQ).docx

PAST PERFORMANCE QUESTIONNAIRE

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

Phone Number: Email Address:

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 the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

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

Contract Location:

Award Date (mm/dd/yy):

Contract 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:

How is this project relevant to project of 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 (mm/dd/yy):

8. Client’s Signature:

NOTE: Clients are highly encouraged to submit completed questionnaires directly to the Government, in which case the Government may then contact the client for confirmation of past performance. Alternatively, the client may complete this questionnaire and submit it directly back to the offeror. The offeror will then submit the completed questionnaire with their proposal. The Government reserves the right to verify any and all information on this form.

Past Performance Questionnaire

(PPQ)

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

effective.

A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner. There should have been no significant weaknesses identified.

performing beyond the requirements of the contract.

unsatisfactory rating.

negative.

TO BE COMPLETED BY CLIENT

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY:

a) Ability to meet quality standards specified for technical performance

U

N

b) Timeliness/effectiveness of contract problem resolution without extensive customer guidance

VG

S

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)

3. CUSTOMER SATISFACTION:

a) To what extent were the end users satisfied with the project?

U

N

b) Overall customer satisfaction

U

N

4. MANAGEMENT/ PERSONNEL/LABOR

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

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

c) Effectiveness of overall management (including ability to effectively lead, manage and control the program)

5. COST/FINANCIAL MANAGEMENT

a) Ability to meet the terms and conditions within the contractual price(s)?

b) Was this contract partially or completely terminated for default or convenience or are there any pending terminations? If yes, please explain below.

Yes

No

c) Have there been any indications that the contractor has had any financial problems? If yes, please explain below.

Yes

No

6. SAFETY/SECURITY

a) Contractor complied with all safety requirements for the project and personnel security requirements.

7. GENERAL

a) Compliance with contractual terms/provisions (explain if specific issues)

b) Would you hire or work with this firm again? (If no, please explain below)

c) Provide an overall rating for the work performed by this contractor.

Please provide 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 assist our office in evaluating performance risk (please attach additional pages if necessary):