J.P-3 Project Verification Form (Amd 0004).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 (Current as of AMD 0004)
In accordance with Sections 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 Contractor performed the work detailed in Parts II and III.
JV, MRCL, and MAS CTA Project Experience Verification: To verify work performed as a member of a JV (or to claim work by way of a MRCL), the Offeror must identify the project of the JV (or MRCL other entity) that the member elects to use for its experience in Part II. The member enters their portion of the work into the “Total Project Value Performed By Offeror/Member.” The Project Verification Form must be signed by a member of the JV (other than the Offeror) within Part V. Certification is not required in Part V if a meaningful relationship to the Offeror exists, and a commitment letter is provided per Section L.5.1.4.
To verify work performed as a JV other than the Offering Entity, relevant experience from a previous joint venture that was composed of the same members as the offering joint venture entity shall be treated as the relevant experience of the Offering JV. The previous JV projects may be claimed under the offering JV’s name and UEI. Certification in Part V is not required. See Section L.5.1.7.3 and ensure complete copies of both the current and former JV agreements are provided.
To verify work performed as a member of a MAS CTA (when a contract award form and/or FPDS report was not issued to the member), the Project Verification Form must be signed by a member of the MAS CTA (other than the offeror) OR the CO, COR, or other Government employee within Part VI, verifying the Contractor performed the work detailed in Parts II and III.
Customer, Joint Venture, or Certifying MAS CTA Member: You are receiving this form because the Contractor claims that it performed the project identified in this form and is using the project to demonstrate experience in response to the OASIS+ Solicitation. To verify the Contractor’s claimed project experience, please ensure you sign this form, certifying the Contractor identified in Part II 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
PART I: OFFEROR INFORMATION
OFFEROR NAME:
OFFEROR UEID:
If work was performed as a Joint Venture (or claimed under a MRCL)
JOINT VENTURE (OR MRCL
OTHER ENTITY) NAME:
JOINT VENTURE (OR MRCL
OTHER ENTITY) UEID:
PART II: PROJECT IDENTIFICATION (Contractor who performed the work)
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)
TOTAL CONTRACT OR ORDER
VALUE:
PROJECT NAICS/PSC Code:
The following information is only required to verify work performed as member of a joint venture or MAS CTA (when an individual award form was not issued to the member):
TOTAL PROJECT VALUE
PERFORMED BY
OFFEROR/MEMBER:
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 (if applicable):
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 (if applicable):
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 (if applicable:):
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 (if applicable):
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 (if applicable):
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 (if applicable):
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 (if applicable):
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).
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, UXOs, 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 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 Contracting Officer or Corporate Official named in this section certifies the Contractor identified in Part II performed the project as detailed in Parts II and III.
NAME OF CONTRACTING
OFFICER OR CORPORATE
OFFICIAL (required):
TITLE:
EMAIL (required):
PHONE NUMBER (required):
AGENCY OR CUSTOMER:
SIGNATURE OF CONTRACTING
OFFICER OR CORPORATE
OFFICIAL:
DATE:
For federal projects: If Contracting Officer signature is not available, then Contracting Officer Representative, or other Government representative with cognizance over the submitted project.
By signing this section, the COR or Government representative named in this section certifies the Contractor identified in Part II performed the project as detailed in Parts II and III.
NAME OF COR OR OTHER
GOVERNMENT
REPRESENTATIVE:
TITLE:
EMAIL:
PHONE NUMBER:
AGENCY OR CUSTOMER:
SIGNATURE OF COR OR
GOVERNMENT
REPRESENTATIVE:
DATE:
PART V: JOINT VENTURE CERTIFICATION (if applicable)
By signing this section, the joint venture member named in this section certifies the Contractor identified in Part II performed the project as detailed in Parts II and III.
JOINT VENTURE MEMBER
NAME:
JOINT VENTURE MEMBER UEID:
CORPORATE OFFICIAL NAME:
CORPORATE OFFICIAL TITLE:
EMAIL:
PHONE NUMBER:
SIGNATURE:
DATE:
PART VI: MAS CTA MEMBER CERTIFICATION (if applicable)
By signing this section, the MAS CTA member named in this section certifies the Contractor identified in Part II performed the project as detailed in Parts II and III.
CORPORATE OFFICIAL NAME:
CORPORATE OFFICIAL TITLE:
COMPANY NAME:
EMAIL:
PHONE NUMBER:
SIGNATURE:
DATE:
| Relevance Narrative: |
| 1 QP minimum average annual value for Domain 1: |
| 2 Average annual value of relevant work for Domain 1: |
| Relevance Narrative_2: |
| Identify Domain #1: |
| Identify Domain #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: |
| Identify Domain #3: |
| Identify Domain #4: |
| 1 QP minimum average annual value for Domain 4: |
| 2 Average annual value of relevant work for Domain 4: |
| Relevance Narrative_5: |
| Identify Domain #5: |
| Relevance Narrative_7: |
| 1 QP minimum average annual value for Domain 7: |
| 2 Average annual value of relevant work for Domain 7: |
| Identify Domain #7: |
| Relevance Narrative_8: |
| Identify Domain #8: |
| 1 QP minimum average annual value for Domain 8: |
| 2 Average annual value of relevant work for Domain 8: |
| Performance spanned 3 or more distinct functional areas ref: Off |
| Performance spanned 4 or more subareas detailed in section: Off |
| Performance spanned 5 or more different Labor Categories: Off |
| Performance spanned 5 or more distinct functional areas ref: Off |
| Performance spanned 5 or more subareas outlined within the: Off |
| Emergency Call Back After Hours Demonstrate performance: Off |
| Emergency Work RequestResponse Demonstrate: 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 |
| Staffing personnel with individual security clearances Secret: Off |
| Surge Capability providing surge support 10 QP value: 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 |
| Environmental Permitting and Compliance: Off |
| Environmental Regulatory Development and Implementation: Off |
| Hazardous Waste Operations and Emergency Response: Off |
| RCRA Requirements: 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 |
| undefined: Off |
| NAME OF CONTRACTING OFFICER OR CORPORATE OFFICIAL: |
| CO OR CORPORATE OFFICIAL TITLE: |
| CO OR CORPORATE EMAIL: |
| CO OR CORPORATE PHONE NUMBER: |
| AGENCY OR CUSTOMER: |
| CO DATE: |
| NAME OF COR OR OTHER GOVERNMENT REPRESENTATIVE: |
| COR OR GOV TITLE: |
| COR OR GOV EMAIL: |
| COR OR GOV PHONE NUMBER: |
| AGENCY OR CUSTOMER_2: |
| COR OR GOV DATE: |
| CO OR CORPORATE OFFICIAL SIGNATURE: |
COR OR GOV SIGNATURE:
| JOINT VENTURE MEMBER NAME: |
| JOINT VENTURE MEMBER UEID: |
| JV MEMBER NAME: |
| JV MEMBER TITLE: |
| JV MEMBER EMAIL: |
| JV MEMBER PHONE NUMBER: |
| JV MEMBER DATE: |
| MAS CTA MEMBER NAME: |
| MAS CTA MEMBER TITLE: |
| MAS CTA MEMBER COMPANY NAME: |
| MAS CTA MEMBER EMAIL: |
| MAS CTA MEMBER PHONE NUMBER: |
| MAS CTA MEMBER DATE: |
| Contingency Exercise Support: Off |
| Environmental Community Relations Public Participation: Off |
| Investigation andor Remediation: Off |
| Performance spanned 3 or more of the following specialized functional sub-areas: Off |
| Surge Capability: Off |
| Competitive task order in MAIDIQ MABOA or MABPA environment: Off |
| RD effort performed through the SBIRSTTR programs: Off |
| Applied Research or ExperimentalExploratoryAdvanced Development: Off |
| Project with an assessed Technology Readiness Level TRL: Off |
| 1 QP minimum average annual value for Domain 5: |
| 2 Average annual value of relevant work for Domain 5: |
| Relevance Narrative_6: |
| Identify Domain #6: |
| 1 QP minimum average annual value for Domain 6: |
| 2 Average annual value of relevant work for Domain 6: |
| TOTAL PROJECT VALUE PERFORMED BY OFFERORMEMBER: |
| OFFEROR NAME: |
| OFFEROR UEID: |
| JOINT VENTURE OR MRCL OTHER ENTITY NAME: |
| JOINT VENTURE OR MRCL OTHER ENTITY UEID: |
| CONTRACTOR NAME: |
| CONTRACT NUMBER: |
| ORDER NUMBER if applicable: |
| PROJECT NAME: |
| FUNDING AGENCY ID OR CUSTOMER: |
| TOTAL PERIOD OF PERFORMANCE INCLUDING OPTIONS: |
| TOTAL CONTRACT OR ORDER VALUE: |
| PROJECT NAICS PSC Code: |
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