2. Attachment 1. Capability Statement.pdf

Attachment 1 - Capability Statement

SECTION 1. GENERAL

1. Business Name: ____________________________ (Insert Business Name)

2. Business Address: ____________________________

____________________________ (Insert Business Address)

3. Cage Code: __________(Insert Cage Code)

4. NAICS Codes: _______________________________(Insert all applicable NAICS Codes)

5. Responsible Point of Contact:

Name: ____________________________ (Insert Name) Telephone: ____________________________ (Insert Telephone Number) Email: ____________________________ (Insert Email Address)

Check All That Apply: Our firm is:

Small business 8(a) small business Veteran-owned small business Service-disabled veteran-owned small business HUBZone small business Small disadvantaged business Women-owned small business concern.

None of the above.

SECTION 2. CONTRACTOR ARRANGEMENT

1. Our firm will be proposing on this project as a:

Sole contractor Prime contractor performing at least 50% of the work with subcontractor(s) Prime contractor performing at least 50% of the work with the following team member subcontractor(s) (Insert business name, business size, cage code, and work which will be subcontracted).

Joint venture with (Insert business name, business size, and cage code).

SECTION 3. CAPABILITY

1. If awarded a contract, the maximum capacity our firm can adequately perform and provide financial responsibility for any contract ______________ (Insert maximum capacity in dollars).

2. Our firm has/ has not performed work in Somalia. (Check box)

3. Our firm is/ is not capable and interested in performing work in Somalia. (Check box)

4. Our firm has/ has not the necessary documents/permits/certifications required to perform work in Somalia. (Check box)

5. Our firm has/ has not constructed projects on military bases in Somalia. (Check box)

6. Our firm does/ does not have the capability, qualifications, AND EXPERIENCE to execute sustainment, restoration and modernization (SRM) projects in an overseas environment, to include LOGISTICAL SUPPORT, MEDICAL SUPPORT, AND SECURITY for our personnel, materials and equipment, including subcontractors and suppliers.

7. If awarded a contract, our firm is/ is not capable to perform at least 20% of the cost of the construction and related services.

8. Based on your previous experience, identify the percent work effort you would expect to subcontract. ____________________________

10. Our firm is/ is not experienced in obtaining Defense Base Act (DBA) insurance for our personnel.

11. Our firm is/ is not experienced with operating under Synchronized Pre-deployment and Operational Tracker (SPOT) requirements.

12. Our firm has/ does not have the capability to perform and multiple sites per year up to the amount of up to $2,000,000.

SECTION 4. PAST PERFORMANCE

Our firm is performing, or has successfully executed SRM projects in support of military facilities. For each example below, provide a description of the scope and complexity.

Example 1:

CONTRACT IDENTIFICATION

Contract Description:

Contract Number:

Contract Type:

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

U.S. Government Agency/Entity:

Telephone Number:

E-mail Address:

Example 2:

CONTRACT IDENTIFICATION

Contract Description:

Contract Number:

Contract Type:

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

U.S. Government Agency/Entity:

Telephone Number:

E-mail Address:

SECTION 5. RETURN INSTRUCTIONS

After you have completed all sections of the capability statement, please return this form to SFC Doug Huddy at douglas.l.huddy.mil@mail.mil. Information provided is for market research purposes only.