B08_Attachment_4_-_Solit_PSP_0003.docx

For Technical Volume I:

1. Experience Questionnaire

2. Subcontractor Reference

3. Key Personnel Qualifications

4. Past Performance Questionnaire

For Business & Price Volume II:

1. Small Business Subcontracting Plan

2. SF 24 Bid Bond

3. Contract Price Schedule

4. General References

5. Hazardous Materials Identification Listing

6. Report on Limitation on Subcontracting

Project Experience Questionnaire Solicitation: 140P2022R0069 Submit responses to the questions below that address experience relative to the elements noted under the Project Experience evaluation subfactor in solicitation section L. Limit submittals to the quantity of projects and timeframes required in the solicitation. Expand the response sections shown below as needed to adequately address each question (this questionnaire may be expanded to multiple pages if needed).

Offeror Company Name

REFERENCED PROJECT INFORMATION

Brief Project Description Description

CONTRACTOR LIST

List Contractor(s) whose experience on the referenced project is being submitted for evaluation on this proposed project. If more than one contractor is listed (i.e. prime and subcontractors), provide information specific to that contractor.

Contractor Name

Role on Referenced Project (Prime or Sub)

Trade

Price (list for each contractor’s specific work) Performance Period (calendar days) (list for each contractor’s specific work)

Mechanical

Subcontractor

PROJECT EXPERIENCE QUESTIONS

1. Describe the project work performed by all contractors listed above.

Response

2. Identify which Project Experience elements listed in section L of the solicitation each contractor’s work addresses.

Response

3. Describe & provide reasons for any changes to the original price for the work described in question 2 above.

Response

4. Describe and provide reasons for any changes to the original schedule for the work described in question 2 above.

Response

5. Describe problems, associated with the work described in question 2 above, which were encountered and how they were resolved. Describe how the offeror’s proposal accounts for similar issues.

Response

6. Describe the means and methods, associated with the work described in question 2 above, which were successful. Would you implement the same means and methods on the proposed project? Why or why not?

Response

7. Provide any other additional project information you believe should be presented.

Response

PAST PERFORMANCE QUESTIONNAIRE

SOLICITATION NO. 140P2022R0069

INSTRUCTIONS: Offeror to complete Sections A and B and transmit questionnaire to reference. Reference to complete Sections C and D and transmit back to Contracting Officer listed in section E.

Notice to Contractor Information provided in this questionnaire is intended for use as source selection information and as such is deemed Source Selection Sensitive. Statements or comments provided in the questionnaire do not signify an express or implied endorsement of any product, supply, service, or enterprise.

This information shall not be construed as an endorsement by the Government or its employee(s) of the contractor for advertising purposes or in a manner that implies the contractor, its products, or services, are approved, endorsed, or considered by the Government to be superior to other products or services.

The contractor shall not be permitted to use any information provided in this questionnaire to publicize, or otherwise circulate, promotional materials that state or imply Governmental, organizational, group, expert, or individual endorsement or consumer testimonial of a product, service, or position which the contractor represents.

A. OFFEROR INFORMATION

B. CONTRACT INFORMATION FOR PAST PROJECT (PROJECT SUBMITTED UNDER PROJECT EXPERIENCE)

C. REFERENCE:

D. EVALUATION

Exceptional Performance met contractual requirements and exceeded many to the owner’s benefit. The element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good Performance met contractual requirements and exceeded some to the owner’s benefit. The element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Unsatisfactory Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The element being assessed contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Quality

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Schedule (& Time Management)

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Cost Control

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Management

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Small Business Subcontracting (& Labor Standards)

Comments (Please provide comments supporting the above ratings. Comments supporting ratings of excellent, marginal, & unsatisfactory are especially helpful.):

Regulatory Compliance

Overall Recommendation:

Overall Comments:

E. RETURN:

BID BOND

(See instructions on reverse)

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0045. We estimate that it will take 1 hour to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.PRINCIPAL (Legal name and business address) TYPE OF ORGANIZATION ("X" one)

INDIVIDUAL PARTNERSHIP

JOINT VENTURE

CORPORATION OTHER (Specify)

STATE OF INCORPORATION

SURETY(IES) (Name and business address)

PERCENT

OF BID PRICE

FOR (Construction, Supplies or Services)

OBLIGATION:

We, the Principal and Surety(ies) are firmly bound to the United States of America (hereinafter called the Government) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" as well as "severally" only for the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit of liability is indicated, the limit of liability is the full amount of the penal sum.

CONDITIONS:

The Principal has submitted the bid identified above. THEREFORE:

The above obligation is void if the Principal - (a) upon acceptance by the Government of the bid identified above, within the period specified therein for acceptance (sixty (60) days if no period is specified), executes the further contractual documents and gives the bond(s) required by the terms of the bid as accepted within the time specified (ten (10) days if no period is specified) after receipt of the forms by the principal; or (b) in the event of failure to execute such further contractual documents and give such bonds, pays the Government for any cost of procuring the work which exceeds the amount of the bid.

Each Surety executing this instrument agrees that its obligation is not impaired by any extension(s) of the time for acceptance of the bid that the Principal may grant to the Government. Notice to the surety(ies) of extension(s) is waived. However, waiver of the notice applies only to extensions aggregating not more than sixty (60) calendar days in addition to the period originally allowed for acceptance of the bid.

WITNESS:

The Principal and Surety(ies) executed this bid bond and affixed their seals on the above date.

PRINCIPAL

SIGNATURE(S)

1.

(Seal) 2.

(Seal) 3.

(Seal)

Corporate Seal

NAME(S) & TITLE(S)

(Typed)

INDIVIDUAL SURETY(IES)

(Seal) 2.

(Seal)

NAME(S)

(Typed)

CORPORATE SURETY(IES)

NAME(S) & TITLE(S)

(Typed)

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is NOT usable

STANDARD FORM 24 (REV. 8/2016)

Prescribed by GSA - FAR (48 CFR) 53.228(a)

NAME(S) & TITLE(S)

NAME(S) & TITLE(S)

NAME(S) & TITLE(S)

NAME(S) & TITLE(S)

NAME(S) & TITLE(S)

NAME(S) & TITLE(S)

INSTRUCTIONS

1. This form is authorized for use when a bid guaranty is required. Any deviation from this form will require the written approval of the Administrator of General Services.

2. Insert the full legal name and business address of the Principal in the space designated "Principal" on the face of the form. An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved.

3. The bond may express penal sum as a percentage of the bid price. In these cases, the bond may state a maximum dollar limitation (e.g., 20% of the bid price but the amount not to exceed dollars).

4. (a) Corporations executing the bond as sureties must appear on the Department of the Treasury's list of approved sureties and must act within the limitations listed therein. The value put into the LIABILITY LIMIT block is the penal sum (i.e., the face value) of the bond, unless a co-surety arrangement is proposed.

(b) When multiple corporate sureties are involved, their names and addresses shall appear in the spaces (Surety A, Surety B, etc.) headed "CORPORATE SURETY(IES)." In the space designated "SURETY(IES)" on the face of the form, insert only the letter identifier corresponding to each of the sureties. Moreover, when co-surety arrangements exist, the parties may allocate their respective limitations of liability under the bond, provided that the sum total of their liability equals 100% of the bond penal sum.

(c) When individual sureties are involved, a completed Affidavit of Individual Surety (Standard Form 28) for each individual surety, shall accompany the bond. The Government may require the surety to furnish additional substantiating information concerning its financial capability.

5. Corporations executing the bond shall affix their corporate seals. Individuals shall execute the bond opposite the word "Corporate Seal"; and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals.

6. Type the name and title of each person signing this bond in the space provided.

7. In its application to negotiated contracts, the terms "bid" and "bidder" shall include "proposal" and "offeror."

STANDARD FORM 24 (REV. 8/2016) BACK

General References READ CAREFULLY: The purpose of this form is for the offeror to provide the Government with general references in the spaces provided as described in the Instructions, Conditions, and Notices to Offerors (Section L). Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their relationships with the references may be considered less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s past performance record. Provide explanations on separate sheets as necessary.

NAME OF CONTRACTOR/OFFEROR:

SURETY

Name of Surety: Address of Surety: Name of Agent: Telephone Number:

CORPORATE BANK

Name of Bank: Address of Bank: Name of Agent: Telephone Number:

Types and Numbers of Accounts:

CORPORATE BANK

Name of Bank: Address of Bank: Name of Agent: Telephone Number:

Types and Numbers of Accounts:

INSURANCE COMPANY

Name:

Address:

Name of Agent:

Telephone Number:

Types of Policies:

SUBCONTRACTOR

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

SUBCONTRACTOR

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

SUBCONTRACTOR

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

MATERIAL SUPPLIER

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material:

MATERIAL SUPPLIER

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material:

MATERIAL SUPPLIER

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material:

Report on Limitations on Subcontracting [Template Version 7/25/19]

This report is required for small business, 8(a) or other socio-economic set-aside service contracts (including construction) priced at or above $150,000.

Type of Service (Required Participation):

[Put an X in the applicable box below per clause 52.219-3, 14, 27,29,30]

1) Services (except construction). 50% maximum may be subcontracted to non-similary situated Subcontractors

2) General construction. 85% maximum may be subcontracted to non-similary situated Subcontractors

3) Construction by special trade contractors. 75% maximum may be subcontracted to non-similary situated Subcontractors

Add additional rows if more than 5 SSSParticipartion Calculation as of the Current Invoice Amounts shown below shall include amounts from all previous invoices and the current invoice. Exclude the cost of materials.

1) Amount Invoiced by the Prime Contractor:

$0

2) Portion of Amount Invoiced for All Similarly Situated Subcontractors (SSS)* $0 Total Amount Paid To:

[Insert SSS company name] $0 Total Amount Paid To:

[Insert SSS company $0 Total Amount Paid To:

[Insert SSS company name] $0 Total Amount Paid To:

[Insert SSS company name] $0 Total Amount Paid To:

[Insert SSS company name] $0

3) Portion of Amount Invoiced for Non-Similarly Situated Subcontractors (NSS) $0 Total Amount Paid To:

[Insert NSS company name] $0 Total Amount Paid To:

[Insert NSS company name] $0 Total Amount Paid To:

[Insert NSS company name] $0 Total Amount Paid To:

[Insert SSS company name] $0 Total Amount Paid To:

[Insert SSS company name] $0

4) Prime & SSS Participation %

#DIV/0!

5) % subcontracted to NSS

#DIV/0!

* Similarly Situated Subcontractor (SSS): is a small business subcontractor that is a participant of the same Small Business Administration (SBA) program that qualified the prime contractor as an eligible offeror and awardee of the contract as defined in 13 CFR 125.6 (i.e. Small Business, HUBZone Business, Service Disabled Veteran Owned Small Business (SDOVB), etc.)

** Limitation on Subcontracting Percentage = (Total amount invoiced by the Prime Contractor - Portion of total amount invoiced for Non-Similarly Situated Subcontractors (NSS)/ Total amount invoiced by the Prime Contractor)

Add additional rows if more than 5 NSS Modify formula if additional rows added above Modify formula if additional rows added above

Corrective Action Plan

If the NSS % noted in line 5 above is not in compliance with the % required by contract clause 52.219-3, 14, 27,29,30 then the prime contractor shall provide a written corrective action plan below:

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