AB133F18RP0006_A0002.pdf

NSN 7540-01-152-8070 STANDARD FORM 30. (Rev. 10-83) Previous Edition unusable Prescribed by GSA FAR (48 CFR) 53.243

Page of Pages AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code

2. AMENDMENT MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (if applicable)

6. ISSUED BY CODE 7. ADMINISTERED BY (If other than item 6) CODE

(x) 9A. AMENDMENT OF SOLICITATION NO.

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NO.

8. NAME AND ADDRESS OF CONTRACTOR (NO., Street, Country, State and ZIP Code)

CODE FACILITY CODE

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of offers is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a) By completing items 8 and 15, and returning ______ copies of amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OR OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment your desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

Check One

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return _______ copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible)

Except as provided herein, all terms and conditions of the document referenced in item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

15B. CONTRACTOR/OFFEROR 16B. UNITED STATES OF AMERICA

(Signature of person authorized to sign)

15C. DATE SIGNED

(Signature of Contracting Officer)

16C. DATE SIGNED

The past performance questionnaire has been updated to include all descriptions of the ratings.

1 6

AB133F18RP0006A0002 DEC 08, 2017 NFFT5000-17-02092

AJ630031

WESTERN ACQUISITION DIVISION

CONTRACTS BRANCH

7600 SAND POINT WAY NE, SOU6

SEATTLE WA 98115-6349

AB133F18RP0006

NOV 30, 2017

See Schedule

Attachment Page

PAGE 2 OF 6 AB133F18RP0006A0002

Instructions to Offerors Sending Reference Questionnaire Forms:

Section A shall be completed by the Offeror (the firm requesting the reference) prior to issuing the questionnaires. The Offeror shall send the questionnaires for relevant projects that are in progress or completed in the past five (5) years to the individuals who will provide the reference. For Government contracts, send to the

Contracting Officer or Technical Representative. For commercial references, send to personnel with duties similar to those for

Government contracts. It is the responsibility of the Offeror to follow-up and encourage references to submit the questionnaire. The completed questionnaire shall be submitted via e-mail directly from the person providing the reference.

Instructions to Person Providing Reference:

In order to assess potential vendors under the Department of Commerce

(DOC), the National Oceanic and Atmospheric Administration (NOAA), Acquisition and Grants Office (AGO), Western Acquisition Division

(WAD) is obtaining past performance information with respect to each

Offeror. As a reference for work performed by the firm identified in

Section A of this questionnaire, your candid response will assist in the evaluation process. Please complete Section B of the questionnaire as thoroughly as possible. The questionnaire must be submitted to noah.nielsen@noaa.gov no later than 2:00 PM PT, January

3, 2017. The subject line in the submission e-mail shall clearly indicate: Fishery Observer Support Services PIROP Past Performance

Questionnaire Submission for <Company Name> and the message shall originate from the reference’s government or commercial e-mail system.

In addition to this questionnaire, you may receive a follow-up phone call to confirm or clarify information. If you have questions regarding this questionnaire or require assistance, please submit inquiries to noah.nielsen@noaa.gov.

PAGE 3 OF 6 AB133F18RP0006A0002

SECTION A

TO BE COMPLETED BY OFFEROR (THE FIRM REQUESTING THE REFERENCE)

PART I: PROTECH OFFEROR INFORMATION

COMPANY NAME AND DIVISION NAME OF OFFEROR:

OFFEROR ADDRESS:

OFFEROR DUNS:

PART II: PAST PERFORMANCE INFORMATION

TITLE OF PROJECT/CONTRACT NUMBER FOR WHICH REFERENCE IS REQUESTED:

PROCUREMENT VEHICLE (e.g. CONTRACT/ORDER/SUBCONTRACT/OTHER):

TYPE OF CONTRACT (e.g. NEGOTIATED, SEALED BID):

PRICING TYPE: (Check all that apply)

___FP ___FPI ___CPFF ___CPAF ___CPIF ___IDIQ ___BOA

___Requirements ___Labor-Hour ___T&M ___Other

(Specify)

DATE OF AWARD:

PERIOD OF PERFORMANCE (INCLUDING OPTIONS):

CONTRACT AMOUNT:

INITIAL CONTRACT DOLLAR VALUE (W/OPTIONS):

FINAL CONTRACT DOLLAR VALUE (W/OPTIONS):

ROLE ON PROJECT:

___PRIME

___SUBCONTRACTOR (EXPLAIN TYPE AND EXTENT OF SUBCONTRACTING, IF

APPLICABLE): OTHER (EXPLAIN)

GENERAL DESCRIPTION OF TYPE OF SERVICES/PRODUCTS REQUIRED UNDER THE CONTRACT:

DESCRIBE COMPLEXITY OF WORK:

PAGE 4 OF 6 AB133F18RP0006A0002

SECTION B

TO BE COMPLETED BY EVALUATOR (PERSON PROVIDING REFERENCE)

PART I: REFERENCE INFORMATION

NAME & TITLE:

ORGANIZATION (INCLUDING AGENCYAND/OR COMPANY):

CONTRACT ROLE (e.g. CO, COR, PM):

ADDRESS:

PHONE NUMBER:

FAX NUMBER:

E-MAIL:

PART II: INFORMATION ABOUT PROJECT/CONTRACT FOR WHICH REFERENCE IS REQUESTED

Please identify and correct any information that is not accurate in Section A.

Please objectively assess the requesting firm in each performance element below by assigning an “X” to the most appropriate rating:

Exceptional: Performance meets contractual requirements and exceeds many to the

Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory: Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal: Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Performance Element Exceptiona l Very Good

Satisfactor y Marginal

Unsatisfact ory

1. QUALITY OF PRODUCT OR SERVICE

Assess the contractor’s performance to contract requirements, specifications, and standards of good workmanship

(e.g. commonly accepted technical, professional, environmental, or safety and health standards).

PAGE 5 OF 6 AB133F18RP0006A0002

Comments:

Performance Element Exceptional Very

Good Satisfactory Marginal Unsatisfactory

2. SCHEDULE

Assess the timeliness of the

Contractor against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g.

efforts that contribute to or affect the schedule).

Comments:

3. COST CONTROL

Assess the contractor’s effectiveness in forecasting, managing, and controlling cost.*

*Cost Control – not required for Firm Fixed Price

(FFP). If FFP please extend N/A in the comments box.

4. BUSINESS RELATIONS

Assess the integration and coordination of all activities needed to execute the contract, specifically the timeliness, completeness, and quality of problem identification, corrective action plans, proposal submittals, the contractor’s history of reasonable and cooperative behavior

(to include timely identification of issues in controversy), customer satisfaction, timely award, and management of subcontractors.

PAGE 6 OF 6 AB133F18RP0006A0002

5. MANAGEMENT OF KEY PERSONNEL

Assess the contractor’s performance in selecting, retaining, supporting, and replacing, when necessary, key personnel.

6. UTILIZATION OF SMALL

BUSINESS

FAR Subpart 19.7 and 15 U.S.C.

637 contains statutory requirements for complying with the Small Business subcontracting Program. Assess whether the contractor provided maximum practicable opportunity for small business to participate in contract performance consistent with efficient performance of the contract.*

*Not required for Small

Businesses.

7. Comments:

8. Additional comments you would like to share

SIGNATURE DATE