Attach 4_Self Scoring Worksheet.xlsx
XLSX spreadsheet 28 KB Posted
- Solicitation number
- HT0011-21-R-0004
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Defense Health Agency
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Instructions
| [Version 110520] |
| OMNIBUS IV SELF SCORING WORKSHEET (draft) |
| INSTRUCTIONS TO OFFERORS |
| 1 | Fill in Offeror's name. | |
| 2 | Go to one or more of the Market Segment tabs that you are proposing on. | |
| 3 | Fill in for each Proficiency Area being proposed, whether information is from the Prime or Subcontractor/Team Member | |
| 4 | If answer to above is Subcontractor or Team Member, then fill in Subcontractor's Name or Team Member's Name. | |
| 5 | See definition of "Level" in RFP Section L and enter your scores based on the following: | |
| Offeror | Level | |
| 8 | Highest Score | |
| 7 | Above Normal Score (upper range) | |
| 6 | Above Normal Score | |
| 5 | Above Normal Score (lower range) | |
| 4 | Normal Score | |
| 3 | Below Normal Score (upper range) | |
| 2 | Below Normal Score | |
| 1 | Below Normal Score (lower range) | |
| 0 | Lowest Score (or Not Applicable) | |
| 6 | Save file. |
R&D
| 0 | |||||||
| MARKET SEGMENT 1: RESEARCH & DEVELOPMENT (R&D) | |||||||
| Proficiency Demonstration Scores | |||||||
| PROFICIENCY AREAS (See SOO for further description) | Prime or Sub / Partner? | Sub Name or Partner Name | PD Part A: Offeror's Core Competencies | PD Part B: What is requred to deliver Part A | PD Part C: Company Experience and Personnel Qualifications satisfying Part B requirements | Score Total | |
| 1 | Collaborations in DoD Medical Research | 0 | 0 | 0 | 0 | ||
| 2 | Transitioning of Programs through Funding Continuum | 0 | 0 | 0 | 0 | ||
| 3 | Maintenance of Quality, Safetry, Security, and Surety Standards | 0 | 0 | 0 | 0 | ||
| 4 | Success in Research Deliverables and Outcomes applying all Federal (e.g., HHS and FDA) and DoD Rules and Regulations | 0 | 0 | 0 | 0 |
R&D SS
| 0 | |||||||
| MARKET SEGMENT 2: RESEARCH & DEVELOPMENT SUPPORT SERVICES (R&D SS) | |||||||
| Proficiency Demonstration Scores | |||||||
| PROFICIENCY AREAS (See SOO for further description) | Prime or Sub / Partner? | Sub Name or Partner Name | PD Part A: Offeror's Core Competencies | PD Part B: What is requred to deliver Part A | PD Part C: Company Experience and Personnel Qualifications satisfying Part B requirements | Score Total | |
| 5 | Administrative Support Services | 0 | 0 | 0 | 0 | ||
| 6 | Information Technology Support Services | 0 | 0 | 0 | 0 | ||
| 7 | Scientific & Technical Support Services | 0 | 0 | 0 | 0 | ||
| 8 | Facilities Support Services | 0 | 0 | 0 | 0 | ||
| 9 | Medical Services Support | 0 | 0 | 0 | 0 | ||
| 10 | Supplies & Equipment | 0 | 0 | 0 | 0 | ||
| 11 | Logistical Support Services | 0 | 0 | 0 | 0 | ||
| 12 | Task Order Administrative, Technical & Other Support | 0 | 0 | 0 | 0 |
RP
| 0 | |||||||
| MARKET SEGMENT 3: REGULATORY PROCESSES (RP) | |||||||
| Proficiency Demonstration Scores | |||||||
| PROFICIENCY AREAS (See SOO for further description) | Prime or Sub / Partner? | Sub Name or Partner Name | PD Part A: Offeror's Core Competencies | PD Part B: What is requred to deliver Part A | PD Part C: Company Experience and Personnel Qualifications satisfying Part B requirements | Score Total | |
| 13 | Animal Use Programs & Vivaria | 0 | 0 | 0 | 0 | ||
| 14 | Research Involving Human Subjects | 0 | 0 | 0 | 0 | ||
| 15 | DoD Use of Investigational Products | 0 | 0 | 0 | 0 | ||
| 16 | Title 21 (Food & Drug Administration) | 0 | 0 | 0 | 0 | ||
| 17 | Federal & DoD Privacy | 0 | 0 | 0 | 0 | ||
| 18 | Technology Transfer | 0 | 0 | 0 | 0 |
TS S&S
| 0 | |||||||
| MARKET SEGMENT 4: TRANSLATIONAL SCIENCE SUPPORT & SERVICES (TS S&S) | |||||||
| Proficiency Demonstration Scores | |||||||
| PROFICIENCY AREAS (See SOO for further description) | Prime or Sub / Partner? | Sub Name or Partner Name | PD Part A: Offeror's Core Competencies | PD Part B: What is requred to deliver Part A | PD Part C: Company Experience and Personnel Qualifications satisfying Part B requirements | Score Total | |
| 19 | Pre-Transition Support | 0 | 0 | 0 | 0 | ||
| 20 | Transition Support | 0 | 0 | 0 | 0 | ||
| 21 | Evidence-based Solution Development | 0 | 0 | 0 | 0 | ||
| 22 | Dissemination Stategies, Processes, and Evidence-based Practices | 0 | 0 | 0 | 0 | ||
| 23 | Implementation Strategies, Processes, and Evidence-based Practicies | 0 | 0 | 0 | 0 | ||
| 24 | Evaluation Strategies, Plans, and Execution | 0 | 0 | 0 | 0 |
TOTALS
| TOTALS | |||||
| MARKET SEGMENTS | |||||
| PROFICIENCY AREAS (See SOO for further description) | Research & Development | R&D Support Services | Regulatory Processes | Translational Science Support & Services | |
| 1 | Collaborations in DoD Medical Research | 0 | |||
| 2 | Transitioning of Programs through Funding Continuum | 0 | |||
| 3 | Maintenantce of Quality, Safety, Security, and Surety Standards | 0 | |||
| 4 | Success in Research Deliverables and Outcomes applying all Federal (e.g., HHS and FDA) and DoD Rules and Regulations | 0 | |||
| Total: | 0 |
| 5 | Administrative Support | 0 |
| 6 | Information Technology Support | 0 |
| 7 | Scientific & Technical Support | 0 |
| 8 | Facilities Support Services | 0 |
| 9 | Medical Services Support | 0 |
| 10 | Supplies & Equipment | 0 |
| 11 | Logistical Support Services | 0 |
| 12 | Task Order Administrative, Technical & Other Support | 0 |
| Total: | 0 |
| 13 | Animal Use Programs & Vivaria | 0 |
| 14 | Research Involving Human Subjects | 0 |
| 15 | DoD Use of Investigational Products | 0 |
| 16 | Title 21 (Food & Drug Administration) | 0 |
| 17 | Federal & DoD Privacy | 0 |
| 18 | Technology Transfer | 0 |
| Total: | 0 |
| 19 | Pre-Transition Support | 0 |
| 20 | Transition Support | 0 |
| 21 | Evidence-based Solution Development | 0 |
| 22 | Dissemination Stategies, Processes, and Evidence-based Practices | 0 |
| 23 | Implementation Strategies, Processes, and Evidence-based Practicies | 0 |
| 24 | Evaluation Strategies, Plans, and Execution | 0 |
| Total: | 0 |
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