Attachment 5: Past Performance Questionaire

Attachment 0003 – Past Performance Questionnaire

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information

Firm Name:
CAGE Code:
Address:
DUNs Number:
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
specify): Contract Title:
Contract Location:

Other (Please

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:

4. Project Description:

Complexity of Work
High
Med
Routine
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:

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR

EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING

DEFINITION

(E) Exceptional

Performance meets contractual
requirements and exceeds many to the
Government/Owner’s benefit. The
contractual performance of the element
or sub-element being assessed was
accomplished with few minor problems
for which corrective actions taken by the
contractor was highly effective.

(VG) Very
Good

Performance meets contractual
requirements and exceeds some to the
Government’s/Owner’s benefit. The
contractual performance of the element
or sub-element being assessed was
accomplished with some minor
problems for which corrective actions
taken by the contractor were effective.

NOTE

An Exceptional rating is
appropriate when the Contractor
successfully performed multiple
significant events that were of
benefit to the Government/Owner.
A singular benefit, however, could
be of such magnitude that it alone
constitutes an Exceptional rating.
Also, there should have been NO