36C24123R0058 0001 Med Gas Survey.docx

DOCX document 117 KB Posted Feb 24, 2023

Attached to: C213--650-22-111 Med Gas Survey, Assessment, and Analysis
Solicitation number: 36C24123R0058
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 1

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File	Type	Posted
Attachment PPQ.docx	DOCX document	Feb 24, 2023
36C24123R0058.docx	DOCX document	Feb 8, 2023

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5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

650-22-111

Department of Veterans Affairs (NCO 1) VAMC Manchester

1750 Elm St, Suite 105 Manchester NH 03104

Department of Veterans Affairs (NCO 1) VAMC Manchester

1750 Elm St, Suite 105 Manchester NH 03104 To all Offerors/Bidders

36C24123R0058 02-23-2023

The purpose of this amendment is to incorporate a Past Performance Questionnaire attachment into the solicitation number shown within block 9A.

Refer to the attached PPQ.

PAST PERFORMANCE QUESTIONAIRE AND COVER LETTER

Complete one set of letters and forms for each project identified in your firm’s SF 330 Section F, Example Projects Which Best Illustrate Proposed Team’s Qualifications for This Contract. Additional space or blank sheets may be added to answer any question.

Transmittal Letter to Accompany Past Performance Questionnaire

FROM:

SUBJECT: Past Performance Questionnaire for Contract(s):

_____________ is currently responding to Department of Veterans Affairs (NCO 1) request for SF 330, Architect-Engineer Qualifications for services to perform Med Gas Survey, Assessment, and Analysis at the Providence RI, VAMC. This Request for SF 330’s requires respondents to identify customers and solicit their response regarding __________ performance.

_______________ is providing past performance data to NCO 1 relating to our performance on contract ______________________________ and have identified _____________ as the point of contact for this contract.

The request for SF 330 instructs that respondents provide customers with the attached questionnaire. Please complete the questionnaire and submit it directly to the NCO 1 Contracting Office Contract Specialist shown below. The requested data should be submitted by email to the Government representative identified below. If the Past Performance Questionnaire is emailed, DO NOT send a hard copy via mail.

Pearl Wray (Contract Specialist) Department of Veterans Affairs Network Contracting Office (NCO 1) E-mail: pearl.wray@va.gov

The information contained in the completed Past Performance Questionnaire is considered sensitive and cannot be released to ____________. Please direct any questions about the acquisition or the attached questionnaire to the VISN 1 NCO point of contact identified above.

Thank you, Signature

A. GENERAL INFORMATION

A-E FIRM TO BE EVALUATED:

Firm Name: _____________ Telephone: _________________

Address: ______________		Email address: ____________________
_______________		Point of Contact: __________________
	__________________________
	__________________________

Firm Cage Code: ________ Firm Tax ID Number:

Firm DUNS Number:

Project Title:

Description of Project:

Description of A-E Firms’ Responsibilities:

Contract Number: __________________ Dollar Amount: $ Contract Period of Performance:

The A-E Firm performed as the Prime Contractor Sub-Contractor/Consultant/Team Member Percent of work performed by A-E Firm: 100% design Other (Please describe) _______________

B. EVALUATOR INFORMATION:

Evaluator’s Company or Agency

Name:_________________.	Evaluator’s Name: _____________________
Address: ____________________	Title of Evaluator: ______________________
___________________		Telephone: _________________
			E-mail: _________________________

C. SEND COMPLETED QUESTIONAIRE (SECTIONS B through D) TO:

Pearl Wray (Contract Specialist) Department of Veterans Affairs Network Contracting Office (NCO 1) E-mail: pearl.wray@va.gov

D. PERFORMANCE INFORMATION: Choose the appropriate rating that most accurately describes the A/E’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ALL RATINGS OF Marginal or Unsatisfactory on page 7 under Narrative Summary.

Exceptional (5)

Very Good (4)

Satisfactory (3)

Marginal (2)

Unsatisfactory (1)

N/A

-Performance meets or met contractual requirements and exceeds or exceeded many of your company’s expectations. The contractual performance reflects or reflected few minor problems and corrective actions taken by the contractor appear to be highly effective or corrective actions taken were effective.

-Performance meets or met contractual requirements and exceeds or exceeded some of your company’s expectations. The contractual performance reflects or reflected some minor problems and corrective actions being taken by the contractor appear to be effective or Corrective actions taken were effective.

-Performance meets or met contractual requirements. The contractual performance reflects or reflected some minor problems. Corrective actions being taken by the contractor appear to be effective or Corrective actions taken were effective.

-Performance does or did not meet some contractual requirements. The contractual performance reflects or reflected serious problems(s) for which the contractor has not yet identified acceptable corrective actions or did not provide acceptable corrective actions.

-Performance does or did not meet most contractual requirements and recovery is not likely or did not occur. The contractual performance contains or contained serious problem (s) for which the contractor’s corrective actions appear ineffective or were ineffective.

-Not applicable or rater has not observed performance in this area.

A-E FIRM’S NAME:

PROJECT NAME:

Contract Period of Performance:

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

Place an “X” in the appropriate column using the definitions matrix on page 4.

Item

FACTORS TO BE RATED

Exceptional (5)

Very Good (4)

Satisfactory (3)

Marginal (2)

Unsatisfactory (1)

N/A

Design Services:

Overall skill level and technical competence of A/E’s personnel.

A/E’s ability to identify and resolve design issues expeditiously.

A/E’s responsiveness to design review questions.

A/E’s ability to effectively coordinate, integrate and manage their consultants/subcontractors/team

A/E’s effectiveness and responsiveness in interfacing with the Client’s staff

Overall accuracy, completeness and coordination of final design documents. (Quality)

A/E’s ability to provide detailed, accurate cost estimates.

A/E’s ability to meet contract schedule.

Follow-On Construction Support Services:

Thoroughness and timely review of construction submittals.

10.

Timely resolution of construction design issues.

11.

Overall quality, responsiveness and timeliness of A/E follow-on construction support services.

LEED (If Applicable):

12.

Overall accuracy, completeness, timeliness and coordination of LEED documentation.

13.

A/E’s ability and understanding of the overall LEED process.

BIM (If Applicable):

14.

Overall accuracy, completeness, timeliness and coordination of BIM documentation.

15.

A/E’s ability and understanding of the overall BIM process.

Owner’s Representative on Design/Build Projects (If Applicable):

16.

Overall accuracy, completeness, timeliness and coordination of requirements documents and bridging documents.

17.

A/E’s ability, thoroughness, timeliness and support as Owner’s Representative throughout the project.

Overall:

18.

How would you rate the A/E’s ability to control cost?

19.

How would you rate the A/E’s overall management performance on this contract?

20.

How would you rate the A/E’s overall technical/quality performance on this contract?

21.

Would you use this A/E again? (If “No”, please comment in the Narrative Summary)

YES

Number of A/E Design Errors & Omissions on Project:		______________
Increased Project Cost Due to A/E Design Errors & Omissions:	______________

CONTRACTOR’S NAME:

PROJECT NAME:

Contract Period of Performance:

Note: Include this information on each page of the questionnaire form to ensure there is no mix up in information among contracts surveyed for respective primes/subs, etc.

NARRATIVE SUMMARY (Use this section to explain any rating from the previous page)

Item

COMMENTS

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File details come from the government source that posted it. Updated Feb 24, 2023.