J.P-3 Project Verification Form (Amd 0001).pdf
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- One Acquisition Solution for Integrated Services Plus (OASIS+) Women-Owned Small Business (WOSB) Set-Aside - Closed Federal contract opportunity
- Solicitation number
- 47QRCA23R0005
- Issued by
- GSA Federal Acquisition Service
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ATTACHMENT J.P-3
PROJECT VERIFICATION FORM
In accordance with Section L.5.2 and L.5.3, this attachment may be used for the following purposes:
● Customer (Federal and Non-Federal) Project experience verification in accordance with L.5.1.7.1 and L.5.1.7.2,
● Joint Venture (JV) project experience verification in accordance with Section L.5.1.7.3,
● Multiple Award Schedule Contractor Teaming Arrangement (MAS CTA) project experience verification in accordance with Section L.5.1.7.4.
Offeror fills out Parts I, II, and III. The Offeror is responsible for submitting the completed form with the claimed Qualifying Project or Federal Experience Project within the proposal.
Project Experience Customer Verification: To obtain customer project experience verification in accordance with L.5.1.7.1 and L.5.1.7.2, this form must be sent to the cognizant Contracting Officer, Contracting Officer’s Representative, other Government employee, or Corporate Officer/Official (customer) to verify the claimed project elements (qualifications). The customer must provide verification within Part IV of this form, verifying the Offeror performed the work detailed in Parts II and III.
JV and MAS CTA Project Experience Verification: To verify the work performed as a member of a Joint Venture or MAS CTA, the Project Verification Form must be signed by a member of the Joint Venture within part V or MAS CTA (other than the Offeror) within part VI, verifying the Offeror performed the work detailed in Parts II and III.
Customer, Joint Venture, or Certifying MAS CTA Member: You are receiving this form because the Offeror claims that it performed the project identified in this form and is using the project to demonstrate experience for its OASIS+ proposal. To verify the Offeror’s claimed project experience, please ensure you sign this form, certifying the that Offeror identified in Part I performed the project as detailed in Parts II and III as follows:
Part IV - Customer Certification/Signature Part V - Joint Venture Certification/Signature Part VI - MAS CTA Certification/Signature
Note: For MAS CTA project verification, this process is not required if individual award forms and FPDS-NG Reports were issued to each member.
PART I: OFFEROR INFORMATION
OFFEROR NAME:
OFFEROR UEID:
If work was performed as a Joint Venture:
JOINT VENTURE NAME:
JOINT VENTURE UEID:
PART II: PROJECT IDENTIFICATION
CONTRACTOR NAME:
CONTRACT NUMBER:
ORDER NUMBER (if applicable):
PROJECT NAME:
FUNDING AGENCY ID OR
CUSTOMER:
TOTAL PERIOD OF
PERFORMANCE, INCLUDING
OPTIONS: (MM/YYYY – MM/YYYY
or MM/YYYY – Present)
PROJECT VALUE:
PROJECT NAICS/PSC Code:
If the Offeror is using this attachment to support “QP - Relevance” to the proposed Domain(s) in accordance with RFP Section L.5.2.3.1, the Offeror shall complete the following sections which describes the relevance to each proposed Domain, and affirms that the relevant portion of the work exceeds the minimum QP criteria for each proposed Domain (e.g. >$500K average annual value). If the Offeror is submitting a QP across multiple Domains, this form may be used to demonstrate/verify relevance for additional proposed domains by providing the requested information for each additional Domain.
Domain #1:
RELEVANCE TO PROPOSED
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #1:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #1:
2) Average annual value of relevant work for Domain #1:
Domain #2:
RELEVANCE TO PROPOSED
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #2:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #2:
2) Average annual value of relevant work for Domain #2:
Domain #3:
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #3:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #3:
2) Average annual value of relevant work for Domain #3:
Domain #4:
RELEVANCE TO PROPOSED
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #4:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #4:
2) Average annual value of relevant work for Domain #4:
Domain #5:
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #5:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #5:
2) Average annual value of relevant work for Domain #5:
Domain #6:
RELEVANCE TO PROPOSED
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #6:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #6:
2) Average annual value of relevant work for Domain #6:
Domain #7:
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #7:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #7:
2) Average annual value of relevant work for Domain #7:
Domain #8:
RELEVANCE TO PROPOSED
DOMAIN(S): The Offeror must include a narrative statement clearly explaining how the project is relevant to each proposed Domain where relevance is claimed (Not to exceed 1000 characters per Domain).
Identify Domain #8:
Relevance Narrative:
RELEVANT WORK MEETS OR
EXCEEDS MINIMUM QP $
THRESHOLD: Offeror must provide two pieces of information which will be validated in PART IV by the customer:
1) QP minimum average annual dollar value for each Domain where relevance is claimed.
2) Average annual value of relevant work for each Domain where relevance is claimed.
1) QP minimum average annual value for Domain #8:
2) Average annual value of relevant work for Domain #8:
PART III: PROJECT QUALIFICATIONS (Offeror must check as applicable)
CAPABILITY QUALIFICATION
INTEGRATED Performance spanned 3 or more distinct functional areas (ref.
Attachment J.P-5, Functional Areas and Sub-Areas).
Performance spanned 4 or more sub-areas detailed in section 1.C.2.7 Facilities Domain of J.P-5.
Performance spanned 5 or more different Labor Categories.
Performance spanned 5 or more distinct functional areas (ref.
Attachment J.P-5).
Performance spanned 5 or more sub-areas outlined within the Environmental Functional Area (ref. Attachment J.P-5).
Performance across all QPs spanned 8 or more distinct functional areas (ref. Attachment J.P-5).
MANAGEMENT &
STAFFING
Emergency Call Back (After Hours): Demonstrate performance where the work consisted of correcting failures that constituted an immediate danger to personnel or property. Response time required was within one hour, or less, of notification.
Emergency Call Back requests include, but are not limited to broken water pipes, electrical power outages, electrical problems that may cause fire or shock, gas or oil leaks, major air conditioning, heating problems or fire alarm malfunctions, etc.
Emergency Work Request/Response: Demonstrate performance where the work consisted of correcting failures that constituted an immediate danger to personnel or property during normal working hours or after working hours. Response time required was within one hour of notification. Emergencies include but are not limited to broken water pipes, water intrusion, stalled elevators with trapped passengers, electrical power outages, electrical problems that may cause fire or shock, gas or oil leaks, major air conditioning or heating problems, etc.
Managing 2 or more first-tier subcontractors/teaming partners.
Managing 3 or more first-tier subcontractors/teaming partners.
Managing 5 or more first-tier subcontractors/teaming partners.
Providing services that involve 5 or more personnel with individual security clearances: Secret, Top Secret, Q (DOE).
Staffing personnel with individual security clearances (Secret, Top Secret, Q (DOE)).
Surge Capability: providing surge support (>10% QP value increase) with < 45 days lead time.
Urgent Work Request/Response: Demonstrate performance where the work consisted of correcting failures that interrupted or adversely impacted building occupant operations but did not pose immediate danger during normal working hours.
Response time required was within 24 hours of notification.
Urgent work requests include but not limited to inoperative electrical circuits, temperature complaints, inoperative lighting above a workstation, flush valve stuck open, any malfunctions to equipment that affect the operations of building and its occupants.
SCALE - ALL OFFERORS
EXCLUDING PROTÉGÉS
Annual value over $500K or 3 FTEs.
Annual value over $1M or 5 FTEs.
Annual value over $2M.
Annual value over $2.5M or 12 FTEs.
Annual value over $3M.
Annual value over $4M or 20 FTEs.
Annual value over $7.5M.
Annual value over $10M.
Annual value over $10M or 50 FTEs.
Annual value over $75M.
Annual value over $100M.
SCALE - PROTÉGÉ
OFFERORS ONLY
Annual value over $250K or 2 FTEs.
Annual value over $500K or 3 FTEs.
Annual value over $1M.
Annual value over $1.25M or 6 FTEs.
Annual value over $1.5M.
Annual value over $2M or 10 FTEs.
Annual value over $3.75M.
Annual value over $5M.
Annual value over $5M or 25 FTEs.
Annual value over $37.5M.
Annual value over $50M.
SPECIALIZED
FUNCTIONAL
EXPERIENCE
CERCLA Requirements.
Climate Change Policy and Sustainability Initiatives.
Contingency & Exercise Support that includes evidence of using SPOT and/or demonstration of SOFA/ACSA knowledge.
Environmental Community Relations, Public Participation, and Stakeholder Engagement.
Environmental Permitting and Compliance.
Environmental Regulatory Development and Implementation Hazardous Waste Operations and Emergency Response (HAZWOPER) by Certified Personnel.
Investigation and/or Remediation of PFAS/PFOA, PCBs, VOCs, or Nuclear/Radiological Contamination.
Performance spanned 3 or more of the following specialized functional sub-areas: Building Management Services, Electrical Maintenance, HVAC Maintenance, Janitorial, Landscaping/Grounds Maintenance, Plumbing and Pipefitting.
RCRA Requirements Surge Capability: providing surge support (>10% QP value increase ) with < 45 days lead time.
MULTIPLE & OCONUS
LOCATIONS
Performance in 3 or more different locations.
Performance in 5 or more different locations.
Performance that involved work at an OCONUS location.
FEDERAL EXPERIENCE:
COMPETITION
Competitive task order in MA-IDIQ, MA-BOA, or MA-BPA environment.
FEDERAL EXPERIENCE:
COST-REIMBURSEMENT
Providing services under cost-reimbursement type contract.
FEDERAL EXPERIENCE:
ADVANCED R&D
R&D effort performed through the SBIR/STTR programs under Phase II or Phase III.
Applied Research or Experimental/Exploratory/Advanced Development as demonstrated by the PSC assigned to the project (PSC contains A in the 1st position and 2 or 3 in the 4th position).
Project with an assessed Technology Readiness Level (TRL) of 3 or higher.
PART IV: CUSTOMER CERTIFICATION
For federal projects: Contracting Officer, Contracting Officer Representative, or other Government employee with cognizance over the submitted project. For non-federal projects: Corporate Officer/Official of the commercial entity with cognizance over the submitted project.
By signing this section, the Customer named in this section certifies the Offeror identified in Part I performed the project as detailed in Parts II and III.
NAME:
TITLE:
AGENCY OR CUSTOMER:
EMAIL:
PHONE NUMBER:
SIGNATURE:
DATE:
PART V: JOINT VENTURE CERTIFICATION
By signing this section, the joint venture member named in this section certifies the Offeror identified in Part I performed the project as detailed in Parts II and III.
JOINT VENTURE MEMBER
NAME:
JOINT VENTURE MEMBER UEID:
NAME:
TITLE:
COMPANY NAME:
EMAIL:
PHONE NUMBER:
SIGNATURE:
DATE:
PART VI: MAS CTA MEMBER CERTIFICATION
By signing this section, the MAS CTA member named in this section certifies the Offeror identified in Part I performed the project as detailed in Parts II and III.
NAME:
TITLE:
COMPANY NAME:
EMAIL:
PHONE NUMBER:
SIGNATURE:
DATE:
| OFFEROR NAME: |
| OFFEROR UEID: |
| JOINT VENTURE NAME: |
| JOINT VENTURE UEID: |
| CONTRACTOR NAME: |
| CONTRACT NUMBER: |
| ORDER NUMBER if applicable: |
| PROJECT NAME: |
| FUNDING AGENCY ID OR CUSTOMER: |
| PROJECT VALUE: |
| PROJECT NAICSPSC Code: |
| Relevance Narrative: |
| 1 QP minimum average annual value for Domain 1: |
| 2 Average annual value of relevant work for Domain 1: |
| Relevance Narrative_2: |
| 1 QP minimum average annual value for Domain 2: |
| 2 Average annual value of relevant work for Domain 2: |
| Relevance Narrative_3: |
| 1 QP minimum average annual value for Domain 3: |
| 2 Average annual value of relevant work for Domain 3: |
| Relevance Narrative_4: |
| 1 QP minimum average annual value for Domain 4: |
| 2 Average annual value of relevant work for Domain 4: |
| Relevance Narrative_5: |
| 1 QP minimum average annual value for Domain 5: |
| 2 Average annual value of relevant work for Domain 5: |
| Relevance Narrative_6: |
| 1 QP minimum average annual value for Domain 6: |
| 2 Average annual value of relevant work for Domain 6: |
| Relevance Narrative_7: |
| 1 QP minimum average annual value for Domain 7: |
| 2 Average annual value of relevant work for Domain 7: |
| Relevance Narrative_8: |
| 1 QP minimum average annual value for Domain 8: |
| 2 Average annual value of relevant work for Domain 8: |
| Performance spanned 5 or more different Labor Categories: Off |
| Performance across all QPs spanned 8 or more distinct: Off |
| Managing 2 or more firsttier subcontractorsteaming partners: Off |
| Managing 3 or more firsttier subcontractorsteaming partners: Off |
| Managing 5 or more firsttier subcontractorsteaming partners: Off |
| Providing services that involve 5 or more personnel with: Off |
| Urgent Work RequestResponse Demonstrate performance: Off |
| Annual value over 500K or 3 FTEs: Off |
| Annual value over 1M or 5 FTEs: Off |
| Annual value over 2M: Off |
| Annual value over 25M or 12 FTEs: Off |
| Annual value over 3M: Off |
| Annual value over 4M or 20 FTEs: Off |
| Annual value over 75M: Off |
| Annual value over 10M: Off |
| Annual value over 10M or 50 FTEs: Off |
| Annual value over 75M_2: Off |
| Annual value over 100M: Off |
| Annual value over 250K or 2 FTEs: Off |
| Annual value over 500K or 3 FTEs_2: Off |
| Annual value over 1M: Off |
| Annual value over 125M or 6 FTEs: Off |
| Annual value over 15M: Off |
| Annual value over 2M or 10 FTEs: Off |
| Annual value over 375M: Off |
| Annual value over 5M: Off |
| Annual value over 5M or 25 FTEs: Off |
| Annual value over 375M_2: Off |
| Annual value over 50M: Off |
| CERCLA Requirements: Off |
| Climate Change Policy and Sustainability Initiatives: Off |
| Contingency Exercise Support that includes evidence of: Off |
| Environmental Community Relations Public Participation and: Off |
| Environmental Permitting and Compliance: Off |
| Environmental Regulatory Development and Implementation: Off |
| Hazardous Waste Operations and Emergency Response: Off |
| Investigation andor Remediation of PFASPFOA PCBs: Off |
| Performance spanned 3 or more of the following specialized: Off |
| RCRA Requirements: Off |
| Surge Capability providing surge support 10 QP value_2: Off |
| Performance in 3 or more different locations: Off |
| Performance in 5 or more different locations: Off |
| Performance that involved work at an OCONUS location: Off |
| Competitive task order in MAIDIQ MABOA or MABPA: Off |
| undefined: Off |
| RD effort performed through the SBIRSTTR programs under: Off |
| Applied Research or ExperimentalExploratoryAdvanced: Off |
| Project with an assessed Technology Readiness Level TRL of: Off |
| NAME: |
| TITLE: |
| AGENCY OR CUSTOMER: |
| EMAIL: |
| PHONE NUMBER: |
| DATE: |
| JOINT VENTURE MEMBER NAME: |
| JOINT VENTURE MEMBER UEID: |
| NAME_2: |
| TITLE_2: |
| COMPANY NAME: |
| EMAIL_2: |
| PHONE NUMBER_2: |
| DATE_2: |
| NAME_3: |
| TITLE_3: |
| COMPANY NAME_2: |
| EMAIL_3: |
| PHONE NUMBER_3: |
| DATE_3: |
| TOTAL PERIOD OF PERFORMANCE INCLUDING OPTIONS: |
| Surge Capability providing surge support 10 QP value: Off |
| Staffing personnel with individual security clearances Secret: Off |
| Emergency Work RequestResponse Demonstrate: Off |
| Emergency Call Back After Hours Demonstrate performance: Off |
| Performance spanned 5 or more subareas outlined within the: Off |
| Performance spanned 4 or more subareas detailed in section: Off |
| Performance spanned 5 or more distinct functional areas ref: Off |
| Performance spanned 3 or more distinct functional areas ref: Off |
| Identify Domain #3: |
| Identify Domain #4: |
| Identify Domain #5: |
| Identify Domain #6: |
| Identify Domain #7: |
| Identify Domain #8: |
| Identify Domain #2: |
| Identify Domain #1: |
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