Past Performance Questionnaire 45667

Solicitation: 70Z04026QSBPL0001 USCG STA SAN FRANCISCO (45667) DD REPAIR

Attachment 1 – Past Performance Questionnaire (PPQ)

U.S. DEPARTMENT OF HOMELAND SECURITY

U.S. COAST GUARD

CG-SEA-C

300 E. MAIN STREET

NORFOLK, VA 23510

PAST PERFORMANCE QUESTIONNAIRE (PPQ)

I.

INSTRUCTIONS

The company (i.e., contractor) that sent you this questionnaire intends to submit an offer in response to a U.S. Coast Guard solicitation and has identified you as a reference to validate their performance. This PPQ must be completed by the person most familiar with the contractors’ performance on a present or previous contract and then submitted directly to the U.S. Coast Guard by the person completing the PPQ. Please DO NOT send the completed PPQ to the contractor being evaluated. In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. We are thanking you in advance for your time, effort, and cooperation in responding to this questionnaire.
Please submit the completed form to the Contract Specialist via E-mail to [email protected]. Please contact the Contract Specialist, Troy.S.Elliott, at (571) 613-0262 if you have any questions. The completed PPQ is due on or before 02 December 2026, 2:00 PM Eastern, unless the due date is extended via a Solicitation Amendment.
II.

GENERAL INFORMATION

A.

PAST PERFORMANCE EVALUATOR & ORGANIZATION/COMPANY INFORMATION

Your Name:

Your Title:
Your Organization/
Company Name:
Address:

Your Phone Number:

Your Fax Number:

Your E-mail Address:

Date:

Your Signature:

“Source Selection Information—See FAR 2.101 and 3.104.”

Solicitation: 70Z04026QSBPL0001 USCG STA SAN FRANCISCO (45667) DD REPAIR

Attachment 1 – Past Performance Questionnaire (PPQ)

B.

CONTRACTOR NAME & CONTRACT IDENTIFICATION

Name of Contractor being evaluated:
Type of Instrument (e.g., Contract,
Purchase Order, Task Order, Other):
Pricing Type (e.g., Fixed Price, Time &
Material, Cost Reimbursement, Other):

Contract or Reference Number:

Subcontract Number (if applicable):

Order Number (if applicable):

Role of Contractor (Prime or Sub)
(if sub, also provide name of prime)

Description of Service/Supply:

Competitive (Y/N):

10 Follow-On (Y/N):

11 Date of Award:

Initial Contract Dollar Value
(w/Options):

13 Final Contract Dollar Value (w/Options):

14 Period of Performance:

15 Place(s) of Performance:

Complexity of Work
(e.g., difficult, routine):

17 If applicable , type and extent of subcontracting:

“Source Selection Information—See FAR 2.101 and 3.104.”