Attachment 3: Past Performance Questionnaire

Attachment 3

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

Defense Health Agency (DHA) Western Markets Contracting Division is considering the Offeror listed below for a U.S. Government contract. Your comments would be appreciated regarding this firm’s past performance. After completing this PPQ, you are highly encouraged to send it back to the Offeror to be submitted with their quote. However, you may return it directly to this office via email to both [email protected] and [email protected] no later than 11:00AM Pacific on 18 November 2026. Your prompt response is greatly appreciated. If the referenced project is a Government project, you may forward a copy of the official performance evaluation in lieu of completing this form. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM. Offeror Information
Name of Offeror Being Evaluated:

Address of Offeror Being Evaluated:

Project Information
Contract Number:

Delivery/Task Order Number:

Contract/Project Title:

Location:

Award Date:

Completion Date:

Contract Value:

Offeror Performed As:
FORMCHECKBOX Prime Contractor FORMCHECKBOX Sub-Contractor Description of Work Performed:

Evaluator Information
Name of Evaluator:

Government Agency/Commercial Company:

Address:

Phone Number:

Email Address:

Position Held in Relation to this Project:

Rating: Please evaluate the past performance using only the following ratings without variation. DO NOT RATE ON A “+” OR “-” SCALE. If a “+” or “-” is used, the rating without the “+” or “-” will be applied. If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form. “E”
Exceptional
Performance greatly exceeded the contract requirements. “VG”
Very Good
Performance exceeded the contract requirements.
“S”
Satisfactory
Performance met the contract requirements.
“M”
Marginal
Performance met the minimum contract requirements, but some material aspects of the contractor’s performance were less than satisfactory. “U”
Unacceptable
Performance was poor and/or did not satisfy contract requirements. “NA”
Not Applicable
No information or did not apply to your contract.

Please rate and provide any supporting information/comments for the following: 1. The relationship between the Offeror and client’s/customer’s contract team:

FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX

E VG S M U NA

2. The Offeror’s management and coordination of subcontractors: