EXHIBIT A PERFORMANCE RELEVANCY SURVEY v2.docx
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- Attached to
- Z2DA-- Renovate Inpatient Wards 6W, 7W & 8W
- Solicitation number
- 36C25620R0128
About this file
This federal solicitation and related exhibit provide details for renovating three inpatient wards at the Overton Brooks VA Medical Center in Shreveport, Louisiana. The procurement will be issued as a 100% set-aside for Service-Disabled Veteran-Owned Small Businesses. Interested offerors must be verified as an SDVOSB through the Vendor Information Pages database. The renovation project has an estimated construction cost between $5-10 million and includes providing all labor, materials, and equipment to complete the scope of work. The performance period is 810 calendar days from the notice to proceed. The solicitation requests offerors to review all documents before submitting any questions by the established cutoff date. Proposals will be due approximately 30 days after the anticipated August 10th solicitation issue date. The contract award is expected within 30 days of receipt of proposals. The exhibit provides a template for offerors to submit past performance references on relevant projects from the last three years for evaluation.
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FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 667-18-105 Renovate Wards 6W, 7W, & 8W 36C25620R0128
EXHIBIT A
PERFORMANCE RELEVANCY SURVEY
PART 1: Provide the following information requested in this format for each of the projects/contracts you intend to have considered for evaluation. Projects may be on-going and cannot have been completed more than 3 years prior to the solicitation issue date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you elect to reference.
A. Offeror Name (Company/Division):
B. Project/Contract Title:
C. Contract Specifics:
| 1. Description of Effort as ( ) Prime Or ( ) Subcontractor | |
| 2. Contract Number: | |
| 3. Original Contract $ Value $ | Current/Final Contract $ Value $ |
| 4. If amounts in 3 above are different, provide a brief description of the reason: |
| 5. Completion Date(s): | |
| a. Original Date: |
b. Current Schedule:
| c. Estimated/Final Completion Date: |
| d. Primary cause for Contract Modifications: |
D. Provide detailed description of the work performed under the contract and describe why you believe the work is VERY REVELANT, RELEVANT, or SEMI-RELEVANT.
Very Relevant Present/past performance effort involved essentially the same scope and magnitude of effort and complexities this solicitation requires.
Relevant Present/past performance effort involved similar scope and magnitude of effort and complexities this solicitation requires.
Somewhat Relevant Present/past performance effort involved some of the scope and magnitude of effort and complexities this solicitation requires.
Descriptions must address the following:
1. Describe the specific elements of the work performed by your firm.
2. Indicate what elements of work were performed by your major subcontractors and indicate if those same subcontractors will be used on this project.
3. Address any technical areas about this project you consider uniquely relevant to this solicitation.
E. Point of Contact for Owner/Government agency Contracting Officer and or inspector (COR / COTR); include a current phone number, email address and facsimile number for each.
Company/Agency Name:
Point of Contact: Title:
Office Phone: Fax: E-mail:
Address of Record:
PART 2: Additional offeror information required, but not project specific. This information need only be provided once in your submission package.
A. Provide information regarding the assessment of liquidated damages on any contracts within the last three years. (Frequency, circumstances, severity of problem, etc.)
B. Offerors are strongly encouraged to include with their proposals information on problems encountered on relevant projects and the specific corrective actions taken to remedy the problems.
C. Other Past Performance Considerations. Information provided shall be limited to the period starting three years prior to the solicitation release date and may include the following:
| 1. | Professional/Industry awards (Identify award type, date of award and copy of certificate if | applicable), Letters of appreciation, recognition or commendations |
| 3. | Discuss unique skills and accomplishments (Explain unique skills and/or accomplishments and | provide supporting information for verification). |
Company Name:
Point of Contact: Title:
Office Phone: Fax: E-mail:
Address of Record:
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