A4_-_Technical_Acceptability_Template.docx

ATTACHMENT 4 — LPTA TECHNICAL ACCEPTABILITY SUBMISSION TEMPLATE

Project Name: BISO – Bandy Creek Water Tank Cyclic Maintenance Park Location: Bandy Creek Campground, Oneida, TN

RFQ No.: TBD

INSTRUCTIONS (READ FIRST):

Offeror shall complete and submit this template with its quotation. To be rated Technically Acceptable (PASS), the quotation must include all required entries below. Omission of any required entry will result in Technically Unacceptable (FAIL) and ineligibility for award. The Government will make award on a Lowest Price Technically Acceptable (LPTA) basis; no tradeoffs. Evaluation will be on the basis established in the solicitation.

1) Contractor Information (Required) Legal name: Click or tap here to enter text.

UEI (if applicable):Click or tap here to enter text.

CAGE (if applicable): Click or tap here to enter text.

Primary POC (name/title): Click or tap here to enter text.

Email / Phone: Click or tap here to enter text.

2) Relevant Experience (PASS/FAIL) — Two (2) completed projects within last five (5) years Each project must demonstrate ALL of the following relevance elements:

· Steel water tank maintenance, coating, or rehabilitation

· Surface preparation (SSPC / NACE standards)

· Application of protective coatings (interior or exterior)

· Confined space or elevated structure work

Project 1 Customer/Owner: Click or tap here to enter text.

Location (city/state): Click or tap here to enter text.

Relevance (check all that apply):

☐ Water tank coating/rehabilitation ☐ Surface prep (SSPC-SP10 or equivalent) ☐ Potable water coating system (NSF/ANSI 61) ☐ Confined space entry work ☐ Elevated structure work Brief scope (1–3 sentences):

Timing evidence (required):

☐ Month/Year–Month/Year ☐ Year completed; Enter: Click or tap here to enter text.

Contract/PO No. (if applicable): Click or tap here to enter text.

POC name/title + email/phone: Click or tap here to enter text.

Project 2 Customer/Owner: Click or tap here to enter text.

Location (city/state): Click or tap here to enter text.

Relevance (check all that apply):

☐ Water tank coating/rehabilitation ☐ Surface prep (SSPC-SP10 or equivalent) ☐ Potable water coating system (NSF/ANSI 61) ☐ Confined space entry work ☐ Elevated structure work Brief scope (1–3 sentences):

Timing evidence (required):

☐ Month/Year–Month/Year ☐ Year completed; Enter: Click or tap here to enter text.

Contract/PO No. (if applicable): Click or tap here to enter text.

POC name/title + email/phone: Click or tap here to enter text.

3) Key Subcontractor Identification (PASS/FAIL) — As applicable Will work be subcontracted ☐Yes ☐ No If yes, identify subcontractor(s) and role(s):

Contractor shall demonstrate capability with qualified personnel:

☐ SSPC/NACE certified coating inspector OR equivalent experience ☐ Confined Space Entry trained personnel (29 CFR 1910.146) ☐ Fall Protection competent person ☐ Coating applicators experienced with AWWA D102 systems ☐ SCADA/telemetry installation capability (or subcontractor identified) Provide names, roles, and qualifications:

Subcontractor name: Click or tap here to enter text.

Trade/role: Click or tap here to enter text.

City/state + phone/email: Click or tap here to enter text.

(Repeat as needed.)

4) SOW/Specs Compliance Checklist (PASS/FAIL) Mark one box per row (no blanks). Notes optional.

Period of Performance:

The offeror acknowledges the period of performance and agrees to complete all services required by the Statement of Work within 90 calendar days from the Award Notice. The offeror has identified below any known or anticipated schedule constraints, material lead times, or other factors that could affect meeting this period of performance.

Known or anticipated delays/constraints: ☐N/A Click or tap here to enter text.

6) Technical Approach (PASS/FAIL) Offeror shall provide a brief (1–2 page max) approach addressing:

· Surface prep method

· Coating system and application

· Containment strategy

· QC/testing plan

· SCADA installation approach

7) Proposal Certification (Required) Authorized representative name/title: Click or tap here to enter text.

Signature: _______________________________________________ Date: Click or tap to enter a date.

By signing above, the offeror certifies that the information provided in this template is accurate and that the quotation fully complies with the Statement of Work and specifications for this contract.