Attachment_1_PPQ.pdf

Addendum to FAR 52.212-1: ATTACHMENT 1 Instructions to Offeror for Sending Past Performance Questionnaire & Sample Past

Performance Questionnaire Form:

Prepare and send a Reference Questionnaire package to a maximum of three (3) of your current or former clients.

For Government contracts, send to the Contracting Officer or Contract Administrator. For commercial references, send to personnel with duties similar to those for Government contracts. It is your responsibility to follow-up and encourage your references to send in their completed questionnaire before the deadline listed in the Solicitation. If you have multiple references at one location, send one cover letter and one questionnaire and list the contracts/orders for which you are requesting references. Each client should not be sent more than one reference package and may combine answers for more than one contract. A copy of the materials to be submitted to references shall be posted electronically and/or provided upon request via e-mail in MS Word format. Your questionnaire package should contain the following:

Cover Letter (see sample below); and Respondent Information Rating Sheets – Offeror should put name, contract number(s), and any other information as indicated in red text below and ensure it is on every page for identification purposes.

-- SAMPLE COVER LETTER –

Offeror Company Letterhead

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm has submitted a proposal under a project advertised by the Contracting Office for the 410th Contracting Support Brigade, Regional Contracting Office (RCO) Miami. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm’s Past Performance. Your candid response to the enclosed Questionnaire will assist in the evaluation process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed Questionnaire as thoroughly as possible. Space is provided for comments.

Understand that while the response to this Questionnaire may be released to the Offeror, FAR 15.306(e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

Please submit your completed Questionnaire directly by e-mail to the Contract Specialist / Contracting Officer, Frances A. De Gori at frances.a.degori.civ@mail.mil and Sherwin D. Riley, sherwin.d.riley.civ@mail.mil. Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return electronically no later than the deadline for proposal submissions as listed in Solicitation W91QEX-19-R-0002. If you have questions regarding the attached questionnaire, or require assistance, please contact Frances A. De Gori at the email listed above, or telephone 305.437.2098. In Ms. De Gori’s absence, please contact Sherwin D. Riley at

305.437.1811. E-mail is preferred. Your questionnaire must be received NOT LATER THAN the deadline for proposal submission as listed in Solicitation W91QEX-19-R-0002.

Thank you for your assistance.

Signature and Title

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Contractor: ____________________ Contract No.: ____________________________ Subcontract No. (If applicable): _________________________________ POC: ________________________ Title: ________________________ (Name) (E.G. PCO/ACO/TM) (Agency, Telephone No., E-mail Address & Fax Number) 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 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)

A. CONTRACT IDENTIFICATION

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:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

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

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

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:

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

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

C. Timeliness of Performance for Services and Product Deliverables.

Good 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).

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

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

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

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

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

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:

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address: