RMACC III ATTACHMENT C

ATTACHMENT C

NAVFAC/USACE/USCG PAST PERFORMANCE QUESTIONNAIRE (Form PPQ)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information

Firm Name:CAGE Code:
Address:DUNs
Phone Number:
Email Address:
Point of Contact:Contact Phone Number:
2. Work Performed as:Prime ContractorSubcontractorJoint Venture Percent of project work performed: If subcontractor, who was the prime (Name/Phone #):
Other (Explain)

3. Contract Information

Contract Number:
Delivery/Task Order Number (if applicable):
Contract Type:Firm Fixed PriceCost ReimbursementOther (Please specify): Contract Title:

Award Date (mm/dd/yy):
Contract Completion Date (mm/dd/yy):
Actual Completion Date (mm/dd/yy):
Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

4. Project Description:

Complexity of WorkHighMedRoutine How is this project relevant to project of submission? 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: USCG REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMIT DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE COMPLETED QUESTIONNAIRE TO USCG WITH THEIR PROPOSAL, AND MAY DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON USCG SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES DIRECTLY TO THE OFFEROR. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

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

78549532639000RATINGDEFINITIONNOTE

(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 a few minor problems for which corrective actions taken by the contractor were highly effective. 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 significant weaknesses identified. (VG) Very Good