36C24826Q0393.docx

SUBJECT*

FY26: STATION (PROJ: N/A) BB Repaint all curbs crosswalks and roadway markings

GENERAL INFORMATION

Network Contracting Office 8 (NCO 8)

8875 Hidden River Pkwy Suite 525 Tampa FL 33637

POINT OF CONTACT*

Contracting Officer Melissa Everett Melissa.Everett@va.gov

PLACE OF PERFORMANCE

Thomas H. Corey VA Medical Center

7305 Military Trail

West Palm Beach FL

ADDITIONAL INFORMATION

DESCRIPTION

COMBINED SYNOPSIS/SOLICITATION 36C24826Q0393

OFFICE ISSUING THIS REQUEST:

Department of Veterans Affairs Network Contracting Office (NCO) 8 Contracting Officer: Melissa Everett Email: Melissa.Everett@va.gov

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) subpart 12.6, “Streamlined Procedures for Evaluation and Solicitation for Commercial Products and Commercial Services,” as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested, and a separate written solicitation document will not be issued.

PART 1 GENERAL INFORMATION

1. This project is 100% Set-Aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSB). AT THE TIME OF PROPOSAL SUBMISSION, interested contractors MUST be actively registered in the following two databases: System for Award Management: https://www.sam.gov and SBA Veteran Small Business Certification: https://veterans.certify.sba.gov.

2. The associated North American Industrial Classification System (NAICS) code for this procurement is 236220 Commercial and Institutional Building Construction with a small business size standard of $45M.

3. Network Contracting Office 8 intends to award a firm fixed price contract for the following work: provide all labor, tools, materials, and equipment necessary to repaint all curbs, crosswalks, and roadway markings on campus. Work will be performed at the Veterans Administration Health Care System, Thomas H. Corey VA Medical Center, 7305 N. Military Trail, West Palm Beach, FL, 33410. Thomas H. Corey VAMC is a smoke free facility.

4. The Magnitude of Construction is between $100,000 and $250,000.

5. The period of performance for this effort is 90 days from the Notice to Proceed.

6. Offer Acceptance Period: Offers providing less than one-hundred and twenty (120) calendar days for Government acceptance after the date offers are due will not be considered and will be rejected.

7. Limitations on Subcontracting: (Reference Contract Clause FAR 52.219-14 for further information): By submission of an offer and execution of a contract, the Offeror agrees that in performance of the contract, the concern will perform at least fifteen (15) percent of the cost of the contract, not including the cost of materials, with its own employees. The formal certification required by VAAR 852.219-75 must be completed, signed, and returned with the quotation. The Government will not consider quotes for award that do not provide a properly completed certification, and all such responses will be deemed ineligible for evaluation and award.

8. Funding is currently available for this award.

9. Bonds: (Reference Contract Clause FAR 52.228-15 for further information on applicability):

A payment and performance bond shall be provided. The penal sum shall be one hundred percent (100%) of order price. Bonds and other payment protection shall be provided within 10 calendar days of award of the Contract. The Notice to Proceed will not be issued until the Contractor provides sufficient bonding to cover the work being performed. Provide electronically only. NCO 8 no longer accepts bonds through the mail.

10. Offer Guarantee (BID BOND): Per FAR Clause 52.228- 1-Bid Guarantee, the amount of the bid guarantee shall be 20 percent of the bid price Or $3,000,000, whichever is less. Provide with price proposal.

11. Site Visit: An organized site visit is scheduled for March 10, 2026, at 10:00 AM EST at the Thomas H. Corey VA Medical Center. Participants are to meet Contracting Officer Representative (CORs) Carolina Coleman at the Engineering Office BC‐231, 7305 N. Military Trail, West Palm Beach, FL 33410. If possible, please notify the Contracting Officer via e‐mail of your firm’s intent on coming to the site visit by March 9, 2026.

12. Requests for Information (RFI): All questions regarding this RFQ must be in writing and sent by e‐mail to Melissa.Everett@va.gov. RFIs must be received no later than March 13, 2026, at 10:00 AM EST. No further questions will be accepted after that date and time. Questions will be answered via an amendment to this. No telephone inquiries will be considered.

13. Wage Determination: Wages for all contractors and subcontractors must comply with Davis Bacon Wage Determinations. The current determination is General Decision FL20260220, dated January 2, 2026. Be advised the determination that is current at the time of the Contract award is the determination that will apply for the project. Current determinations are available at: http://www.sam.gov/

PART 2 PROPOSAL PREPARATION AND EVALUATION INFORMATION

1. Proposals shall be submitted as two different documents, one technical proposal and one price proposal. There should be no pricing information in the technical proposal. Proposals may be in any of the following formats: .pdf, .docx, or .doc. Proposals shall be provided via email to the Contracting Officer at Melissa.Everett@va.gov. Your quote must contain all of the information described below or the quote may be determined nonresponsive.

2. Technical Proposal Format: The technical proposal shall address all information requested in Factors 1 – 3 below. Proposals will then be evaluated against the stated factors. The technical proposal shall include a cover page with the following:

Solicitation Number 36C24826Q0393 Project Title BB Repainting curbs crosswalks and roadway markings on campus Project Number N/A Business Name and Address Point of Contact Name, Phone Number, and Email SAM UEI number

The Government intends to award a contract as a result of this RFQ to the responsible offeror whose offer conforms to the RFQ requirements. A comparative evaluation of the quotes will be made in accordance with FAR 13.106‐2(b). Offerors must be determined responsible according to the standards of FAR Part 9 to be eligible for award.

VA will select the quote that represents the best benefit to the Government to fulfill the requirement based on the judgment of the Contracting Officer and VA users.

Factor 1: Technical Approach The Quoter shall develop and provide their Technical Approach which provides a description of the work to be completed and the equipment and tools to be used. List all the tasks or processes to finish the work. Identify how waste is to be disposed. Identify how the work site will be secured. Identify what the hazards are that may cause potential harm to workers. Identify what safety measures are to be implemented and what will be the emergency procedures in place for the work.

Factor 2: Schedule Offeror shall provide a proposed progress schedule in a time scaled bar graph format. The horizontal axis will be scaled for time beginning with the Notice to Proceed and concluding with contract completion. The vertical axis will show the milestones and major portions of the contract work as stated in Statement of Work section 3.0.

Milestones should include such items as material submissions, submittal acceptance, partial and final inspections, punch list completion, testing, etc. All schedule items will show a start date and a completion date. If there is a known long lead time for materials this must be stated in your proposal. In a brief narrative highlight any potential problems that could affect the project schedule and provide possible contingency plans or potential solutions to avoid such issues.

Factor 3: Past Performance The offeror shall provide past performance information for two projects completed within the last three years that demonstrates your company’s ability to successfully complete a project similar to the work outlined in this solicitation. Provide either a completed CPARS printout or a completed Past Performance Questionnaire (PPQ) that has been signed by the person who filled in the PPQ. If a PPQ is received that is not signed it will not be considered.

3. Price Proposal Format: The price proposal shall provide all information listed below.

a. Cover page with the following:

Solicitation Number 36C24826Q0393 Project Title BB Repainting curbs crosswalks and roadway markings on campus Project Number N/A Business Name and Address Point of Contact Name, Phone Number, and Email SAM UEI number

b. Signed Offer/Acknowledgement of Amendments

c. Bid Bond

d. Completed Project Price Breakdown

e. Limitations on Subcontracting Form The Government will evaluate price based on the total price.

All technical factors, when combined, are more important than price.

PART 2 AWARD

1. The Government will evaluate proposals submitted in response to this solicitation which meet the requirements that have been provided above.

2. This procurement will be a single award on a trade-off basis resulting from this solicitation to the responsible offeror.

3. Award may be made without discussions, except for minor clarifications.

Statement of Work

Repainting curbs crosswalks and roadway markings on campus

I. INTRODUCTION AND SCOPE OF WORK

This service contract is to provide all labor, tools, material, and special equipment necessary to perform a one-time contract for the repainting of the curbs, crosswalks and roadway markings throughout the West Palm Beach VA campus. The Office of High Reliability made a Fall Aggregate for 2025 and found that the physical environment failed to consistently support safe ambulation due to inadequate visibility of walking surfaces and elevation changes. This was caused by faded paint markings, poorly delineated curbs, and insufficient visual contrast at key transition points. These environmental hazards resulted in multiple Veteran falls in parking lots and curbside areas while entering or exiting the facility, leadership submitted an action plan and Facility Management is attempting to provide a one-time service contract to comply with this request by due date. The facility is located at the Department of Veterans Affairs (VA) Thomas H. Corey/West Palm Beach Medical Center, 7305 N. Military Trail, West Palm Beach, FL.

II. REQUIREMENTS

A. Prior to any worker for the contractor begins work, the contractor prepares a safety plan and ensures workers understand and comply with the safety measures while working at VA Medical Center.

B. This project has been structured to support a fully operational, 24/7 healthcare campus, with an emphasis on patient safety, emergency access, and minimal disruption to daily medical operations.

C. The work is divided into seven (7) controlled phases to maintain parking availability, traffic circulation, and facility access throughout construction. Contractor shall coordinate daily with VA Facilities Management and the Contracting Officer’s Representative (COR), maintain continuous emergency access, and secure work areas with barricades, cones, and signage as needed.

Phase 1: Main Entrance Parking level and next to ER Parking.

Phase 2: Cancer Center Parking Lot Phase 3: CLC and Bldg 10 Parking Lots Phase 4: Bldg. 4, 16 and 12 Parking Area (MRI included) Phase 5: Perimeter roads, Roundabout, Ramp and parking areas Lot 12, 23, 17, 10, 21, 22, 11 Phase 6: Employee’s Parking areas Phase 7: Back sides of buildings, Lot 14, Dock 6, 11, 9 areas

D. Provide labor, materials, equipment, and traffic control to re-stripe parking areas, drive aisles, roadway markings, and related pavement markings across the VA campus in seven phases. Work includes typical items such as standard stalls, ADA stalls and stencils, directional arrows, stop bars, curb painting, and pavement messages where existing. All striping will be applied using one (1) coat of standard Acrylic Water base traffic marking paint and will follow existing approved layouts unless otherwise directed by the COR.

E. To maintain VA operations, Work shall be nights, weekends, and off-peak hours as required to minimize disruption. Maintain continuous emergency vehicle access at all times. Coordinate daily work limits and access routes with VA Facilities and the COR. Install and maintain temporary barricades, cones, signage, and flagging as required. Phase work to keep parking and circulation operational wherever possible. Restore work zones to a safe, usable condition at the end of each shift.

F. All work areas will be clearly delineated and secured. Traffic flow and pedestrian routing will be maintained in accordance with VA direction and ADA requirements. Pedestrian pathways will be protected and clearly marked. Work zones will be restored to a safe, usable conditions at the end of each shift.

G. Striping shall follow existing approved layouts unless otherwise directed. Paint application shall comply with manufacturer recommendations and weather limitations. All markings shall be inspected for clarity, alignment, and compliance prior to demobilization.

E. Contractor shall schedule around required delays by the hospital staff and may have to repeat attempts to complete some areas. These delays shall be coordinated with the Medical Center POC.

III. DELIVERY

Performance of services shall be rendered as identified above. Contractor shall report to the COR, commencing work.

IV. PROGRESS AND COMPLIANCE

A. Contractor shall perform services on this order only to the extent indicated on this agreement. No additional services/repairs will be made without the approval of the Contracting Officer and the COR.

B. All payments shall be made in arrears. Upon receipt of Contractor’s invoices, the COR will certify invoices, assuring that all services were performed in accordance with contract terms.

Additional requirements:

All work shall be in accordance with NFPA, Occupational Safety and Health Administration (OSHA), VA standards, and other related codes.

All work shall be completed within 90 days of award and shall be scheduled with the Medical Center POC in advance.

Workmen are subject to all the rules of the Medical Center.

Contractor tools and equipment shall be continuously under direct line of sight supervision of the contractor. NO tools / equipment can be left at the individual work sites overnight – must put away each day.

Contractor shall clean-up work sites DAILY. NO debris can be left at work sites.

Contractor performing work shall provide all necessary certifications, and other related documentation before the start of the project to Medical Center POC.

Materials and workmanship shall be warranted for one (1) year from final completion.

A site visit is highly recommended to allow prospective contractors to verify all existing conditions and include all such implications in the proposal.

(1) The Contracting Officer is the only one authorized to schedule any site visit.

See attached document: S02 RFQ Attachment - WD FL20260220 dated 01-02-2026.

See attached document: S02 RFQ Attachment - VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING.

Combined Synopsis/Solicitation Notice Combined Synopsis/Solicitation Notice See attached document: S02 RFQ Attachment - Project Price Breakdown.

Combined Synopsis/Solicitation Notice

See attached document: S02 RFQ Attachment - Past Performance Questionnaire.

WD FL20260220 dated 01-02-2026 "General Decision Number: FL20260220 01/02/2026

Superseded General Decision Number: FL20250220

State: Florida

Construction Type: Building

County: Palm Beach County in Florida.

BUILDING CONSTRUCTION PROJECTS (does not include single family homes or apartments up to and including 4 stories).

Modification Number Publication Date 0 01/02/2026

ASBE0060-001 03/01/2025

Rates Fringes

ASBESTOS WORKER/HEAT & FROST

INSULATOR........................$ 39.76 19.02

CARP1809-002 08/01/2016

Rates Fringes

CARPENTER: PILEDRIVERMAN.........$ 25.20 10.36

ELEC0728-001 03/01/2025

Rates Fringes

ELECTRICIAN (Includes Low Voltage Wiring)..................$ 40.25 15.20

ELEV0071-002 01/01/2025

Rates Fringes

ELEVATOR MECHANIC................$ 55.85 38.435+a+b

FOOTNOTE:

a: Employer contributes 8% basic hourly rate for 5 years or more of service or 6% basic hourly rate for 6 months to 5 years of service as Vacation Pay Credit;

b. Paid Holidays: New Year's Day; Memorial Day; Independence Day; Labor Day; Veteran's Day; Thanksgiving Day; plus the Friday after Thanksgiving; and Christmas Day.

ENGI0487-019 07/01/2023

Rates Fringes

OPERATOR:

Backhoe/Excavator/Trackhoe.......$ 27.00 14.90

ENGI0487-020 07/01/2023

Rates Fringes

OPERATOR: Concrete Pump.........$ 32.75 14.90

ENGI0487-023 07/01/2023

Rates Fringes

OPERATOR: Crane All Cranes 75 Tons and below.......................$ 37.07 14.90 All Cranes Over 300 Ton, Electric Tower, Luffing Boom Cranes.................$ 40.40 14.90 Cranes 130-300 Ton..........$ 39.38 14.90 Cranes 76 ton to 129 Ton....$ 37.57 14.90

ENGI0487-029 07/01/2023

Rates Fringes

OPERATOR: Forklift..............$ 26.75 14.90 OPERATOR: Mechanic..............$ 37.07 14.90 OPERATOR: Oiler.................$ 27.53 14.90

IRON0402-005 10/01/2024

Rates Fringes

IRONWORKER (Ornamental and Structural)......................$ 28.90 15.66

PLUM0630-006 07/01/2025

Rates Fringes

PIPEFITTER (Includes HVAC Pipe, Unit and Temperature Controls Installations)..........$ 36.66 21.01

PLUM0630-007 07/01/2025

Rates Fringes

PLUMBER..........................$ 36.66 21.01

SFFL0821-004 07/01/2025

Rates Fringes

SPRINKLER FITTER (Fire Sprinklers)......................$ 35.03 24.00

SHEE0032-002 08/12/2023

Rates Fringes

SHEET METAL WORKER, Includes HVAC Duct Installation...........$ 29.10 14.68

SUFL2014-029 08/16/2016

Rates Fringes

CARPENTER, Includes Acoustical Ceiling Installation, Drywall Finishing/Taping, Drywall Hanging, Form Work, Metal Stud Installation................$ 16.98 0.00

CEMENT MASON/CONCRETE FINISHER...$ 13.06 0.70

IRONWORKER, REINFORCING..........$ 18.67 0.00

LABORER: Common or General, Including Cement Mason Tending...$ 12.39 0.00

LABORER: Pipelayer..............$ 13.56 1.34

OPERATOR: Bulldozer.............$ 15.40 1.90

OPERATOR: Grader/Blade..........$ 18.97 0.00

OPERATOR: Loader................$ 16.00 2.82

OPERATOR: Roller................$ 14.43 4.78

PAINTER: Brush, Roller and Spray............................$ 16.00 3.48

ROOFER...........................$ 20.45 4.77

TILE SETTER......................$ 18.01 0.00

TRUCK DRIVER: Dump Truck........$ 13.22 2.12

TRUCK DRIVER: Lowboy Truck......$ 14.24 0.00

WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental.

Note: Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal Contractors applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2017. If this contract is covered by the EO, the contractor must provide employees with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid sick leave each year.

Employees must be permitted to use paid sick leave for their own illness, injury or other health-related needs, including preventive care; to assist a family member (or person who is like family to the employee) who is ill, injured, or has other health-related needs, including preventive care; or for reasons resulting from, or to assist a family member (or person who is like family to the employee) who is a victim of, domestic violence, sexual assault, or stalking. Additional information on contractor requirements and worker protections under the EO is available at https://www.dol.gov/agencies/whd/government-contracts.

Note: Executive Order 13658 generally applies to contracts subject to the Davis-Bacon Act that were awarded on or between January 1, 2015 and January 29, 2022, and that have not been renewed or extended on or after January 30, 2022. Executive Order 13658 does not apply to contracts subject only to the Davis-Bacon Related Acts regardless of when they were awarded.

If a contract is subject to Executive Order 13658, the contractor must pay all covered workers at least $13.30 per hour (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in 2025. The applicable Executive Order minimum wage rate will be adjusted annually. Additional information on contractor requirements and worker protections under Executive Order 13658 is available at www.dol.gov/whd/govcontracts.

Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29CFR 5.5 (a) (1) (iii)).

The body of each wage determination lists the classifications and wage rates that have been found to be prevailing for the type(s) of construction and geographic area covered by the wage determination. The classifications are listed in alphabetical order under rate identifiers indicating whether the particular rate is a union rate (current union negotiated rate), a survey rate, a weighted union average rate, a state adopted rate, or a supplemental classification rate.

Union Rate Identifiers

A four-letter identifier beginning with characters other than ""SU"", ""UAVG"", ?SA?, or ?SC? denotes that a union rate was prevailing for that classification in the survey. Example:

PLUM0198-005 07/01/2024. PLUM is an identifier of the union whose collectively bargained rate prevailed in the survey for this classification, which in this example would be Plumbers.

0198 indicates the local union number or district council number where applicable, i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. The date, 07/01/2024 in the example, is the effective date of the most current negotiated rate.

Union prevailing wage rates are updated to reflect all changes over time that are reported to WHD in the rates in the collective bargaining agreement (CBA) governing the classification.

Union Average Rate Identifiers

The UAVG identifier indicates that no single rate prevailed for those classifications, but that 100% of the data reported for the classifications reflected union rates. EXAMPLE:

UAVG-OH-0010 01/01/2024. UAVG indicates that the rate is a weighted union average rate. OH indicates the State of Ohio.

The next number, 0010 in the example, is an internal number used in producing the wage determination. The date, 01/01/2024 in the example, indicates the date the wage determination was updated to reflect the most current union average rate.

A UAVG rate will be updated once a year, usually in January, to reflect a weighted average of the current rates in the collective bargaining agreements on which the rate is based.

Survey Rate Identifiers

The ""SU"" identifier indicates that either a single non-union rate prevailed (as defined in 29 CFR 1.2) for this classification in the survey or that the rate was derived by computing a weighted average rate based on all the rates reported in the survey for that classification. As a weighted average rate includes all rates reported in the survey, it may include both union and non-union rates. Example: SUFL2022-007 6/27/2024. SU indicates the rate is a single non-union prevailing rate or a weighted average of survey data for that classification. FL indicates the State of Florida. 2022 is the year of the survey on which these classifications and rates are based. The next number, 007 in the example, is an internal number used in producing the wage determination. The date, 6/27/2024 in the example, indicates the survey completion date for the classifications and rates under that identifier.

?SU? wage rates typically remain in effect until a new survey is conducted. However, the Wage and Hour Division (WHD) has the discretion to update such rates under 29 CFR 1.6(c)(1).

State Adopted Rate Identifiers

The ""SA"" identifier indicates that the classifications and prevailing wage rates set by a state (or local) government were adopted under 29 C.F.R 1.3(g)-(h). Example: SAME2023-007 01/03/2024. SA reflects that the rates are state adopted. ME refers to the State of Maine. 2023 is the year during which the state completed the survey on which the listed classifications and rates are based. The next number, 007 in the example, is an internal number used in producing the wage determination.

The date, 01/03/2024 in the example, reflects the date on which the classifications and rates under the ?SA? identifier took effect under state law in the state from which the rates were adopted.

WAGE DETERMINATION APPEALS PROCESS

1) Has there been an initial decision in the matter? This can be:

a) a survey underlying a wage determination

b) an existing published wage determination

c) an initial WHD letter setting forth a position on a wage determination matter

d) an initial conformance (additional classification and rate) determination

On survey related matters, initial contact, including requests for summaries of surveys, should be directed to the WHD Branch of Wage Surveys. Requests can be submitted via email to davisbaconinfo@dol.gov or by mail to:

Branch of Wage Surveys Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W.

Washington, DC 20210

Regarding any other wage determination matter such as conformance decisions, requests for initial decisions should be directed to the WHD Branch of Construction Wage Determinations.

Requests can be submitted via email to BCWD-Office@dol.gov or by mail to:

Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W.

Washington, DC 20210

2) If an initial decision has been issued, then any interested party (those affected by the action) that disagrees with the decision can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7).

Requests for review and reconsideration can be submitted via email to dba.reconsideration@dol.gov or by mail to:

Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W.

Washington, DC 20210

The request should be accompanied by a full statement of the interested party's position and any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue.

3) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board). Write to:

Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W.

Washington, DC 20210.

END OF GENERAL DECISION

VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (NOV 2022)

(a) Pursuant to 38 U.S.C. 8127(k)(2), the offeror certifies that—

(1) If awarded a contract (see FAR 2.101 definition), it will comply with the limitations on subcontracting requirement as provided in the solicitation and the resultant contract, as follows:

(i) [] Services. In the case of a contract for services (except construction), the contractor will not pay more than 50% of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in 852.219–73 or VOSBs as set forth in 852.219–74. Any work that a similarly situated VIP-listed subcontractor further subcontracts will count towards the 50% subcontract amount that cannot be exceeded. Other direct costs may be excluded to the extent they are not the principal purpose of the acquisition and small business concerns do not provide the service as set forth in 13 CFR 125.6.

(ii) [X] General construction. In the case of a contract for general construction, the contractor will not pay more than 85% of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in 852.219–73or VOSBs as set forth in 852.219–74. Any work that a similarly situated VIP-listed subcontractor further subcontracts will count towards the 85% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(iii) [] Special trade construction contractors. In the case of a contract for special trade contractors, the contractor will not pay more than 75% of the amount paid by the government to it to firms that are not VIP-listed SDVOSBs as set forth in 852.219–73 or VOSBs as set forth in 852.219–74. Any work that a similarly situated subcontractor further subcontracts will count towards the 75% subcontract amount that cannot be exceeded. Cost of materials are excluded and not considered to be subcontracted.

(2) The offeror acknowledges that this certification concerns a matter within the jurisdiction of an Agency of the United States. The offeror further acknowledges that this certification is subject to Title 18, United States Code, Section 1001, and, as such, a false, fictitious, or fraudulent certification may render the offeror subject to criminal, civil, or administrative penalties, including prosecution.

(3) If VA determines that an SDVOSB/ VOSB awarded a contract pursuant to 38 U.S.C. 8127 did not act in good faith, such SDVOSB/VOSB shall be subject to any or all of the following:

(i) Referral to the VA Suspension and Debarment Committee;

(ii) A fine under section 16(g)(1) of the Small Business Act (15 U.S.C. 645(g)(1)); and

(iii) Prosecution for violating section 1001 of title 18.

(b) The offeror represents and understands that by submission of its offer and award of a contract it may be required to provide copies of documents or records to VA that VA may review to determine whether the offeror complied with the limitations on subcontracting requirement specified in the contract. Contracting officers may, at their discretion, require the contractor to demonstrate its compliance with the limitations on subcontracting at any time during performance and upon completion of a contract if the information regarding such compliance is not already available to the contracting officer. Evidence of compliance includes, but is not limited to, invoices, copies of subcontracts, or a list of the value of tasks performed.

(c) The offeror further agrees to cooperate fully and make available any documents or records as may be required to enable VA to determine compliance with the limitations on subcontracting requirement. The offeror understands that failure to provide documents as requested by VA may result in remedial action as the Government deems appropriate.

(d) Offeror completed certification/fill-in required. The formal certification must be completed, signed and returned with the offeror’s bid, quotation, or proposal. The Government will not consider offers for award from offerors that do not provide the certification, and all such responses will be deemed ineligible for evaluation and award.

Certification I hereby certify that if awarded the contract, [insert name of offeror] will comply with the limitations on subcontracting specified in this clause and in the resultant contract. I further certify that I am authorized to execute this certification on behalf of [insert name of offeror].

Printed Name of Signee: ___________ Printed Title of Signee: _____________ Signature: ____________ Date: ______________ Company Name and Address: _______________ (End of Clause)

Project Price Breakdown

Base Offer Cost Breakdown

Project Number:

Date:

Project Title

Project Location

Offeror Name

Offeror Street

Offeror City

State

Zip

Overhead/Profit Subtotals :

PAST PERFORMANCE QUESTIONNAIRE

FOR OFFICAL USE ONLY

INSTRUCTIONS TO CONTRACTOR

Complete the CONTRACTOR INFORMATION section, below (type answers into light blue shaded boxes). Save the document. Send an electronic or hard copy print of the form to each of your reference contacts, asking them to please complete the form and submit no later than the solicitation date/time according to the instructions, below.

INSTRUCTIONS TO REFERENCE CONTACT

The contractor named below is submitting an offer for a United States Department of Veterans Affairs contract requirement, and has sent this form to you, in your role as a past performance reference contact. Please complete this form in full (all areas shaded in light yellow). Once completed, please send the form directly to the Contracting Officer via email at Melissa.Everett@va.gov.

GENERAL INFORMATION [Completed by Contractor]

Contractor Company Name

Street Address

Contractor Point of Contact Name

City

Point of Contact Phone Number

State

Reference Project Title

Zip Code

Contract Period of Performance (start to finish):

Email

Contract Number

Contract Dollar Value

Description of Work

RESPONDENT INFORMATION [Completed by Reference Contact]

Company Name

Street Address

POC Name

City

Phone Number

State

Fax Number

Zip Code

Email

PERFORMANCE INFORMATION: Choose the number on the scale of 1 to 5 that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2 in the Remarks section, below (text box will expand to whatever extent is necessary).

YES

NO

YES

NO

YES

NO

REMARKS (Please use as much space as is needed – the box will expand as you type).

Name of Person Completing Form Signature