Attachment 13 - Past Performance Reference Form.docx
DOCX document 33 KB Posted
- Attached to
- Relocatable Modular Buildings
- Solicitation number
- N6523625R3800
About this file
Attachment 13 is a Past Performance Reference Form for a Navy solicitation (N6523625R3800) seeking relocatable modular buildings. The form requires offerors to provide detailed information about three recent government contract references, with at least one contract demonstrating ICS/ICD 705 Accreditation. References must involve projects with an invoiced amount of $3 million or more, focusing on RF Shielding >50dB, site preparation, system design, and hardware installation. Contracts must be current or performed within the last five years, with at least one reference from the prime contractor and the option to include subcontractor references.
The form captures comprehensive performance evaluation data, including CPARS ratings across technical, cost control, schedule, management, and regulatory compliance dimensions. If CPARS is unavailable, a detailed questionnaire must be completed by the contract reference point of contact, assessing conformance to contract requirements, delivery quality, timeliness, customer service, technical support, and warranty responsiveness. The completed form must be emailed directly to specified Navy contract specialists (Bridgette Clayton and Jessie Rehwoldt) by the solicitation response deadline of Wednesday, 18 June 2025 at 10:00 AM EST.
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Other files
| File | Type | Posted |
|---|---|---|
| Modular Questions and Answers 6_26_25.pdf | ||
| Revised Attachment 14 - Delivery Order N6523625FXXXX Pricing Model.xlsx | XLSX spreadsheet | |
| Attachment 14 - Delivery Order N6523625FXXXX Pricing Model.xlsx | XLSX spreadsheet | |
| Attachment 15 - Delivery Order N6523625FXXXX Performance Based Payment Schedule.docx | DOCX document | |
| Attachment 16 - FAR 52.212-3 Alt 1 (Offeror Representations and Certifications).docx | DOCX document |
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Text version
ATTACHMENT 13: PAST PERFORMANCE REFERENCE FORM
Section 1: To Be Completed by Offeror for each Past Performance Reference
Offeror’s Name:
Contract Number:
Total Contract Value:
Modular Delivery Date(s):
☐CPARS or ☐Questionnaire
Applicable Category (Select All That Apply):
a. ☐ Accreditation ICD/1CS 705
b. ☐ RF Shielding >50dB (if selected, please provide the test result)
c. ☐ Site preparation
d. ☐ System Design and Hardware installation
e. Others Click or tap here to enter text.
Brief description of relocatable modular provided (ex: quantity, size of the modular, size of the shielded area, and performance period):
Click or tap here to enter text
Section 2: CPARS Rating Result (When CPARS Available)
| Technical: | Choose an item. | |||
| Cost Control: | Choose an item. | |||
| Schedule/timelines: | Choose an item. | |||
| Management or business relations: | Choose an item. | |||
| Regulatory compliance: | Choose an item. | |||
| Other: | Choose an item. |
If CPARS is unavailable, then offerors shall identify Contract references below for each Past Performance Reference that will be submitting a response to the Government POC.
Contractor Point of Contact Information (Representative who can verify data):
Name: ______________________________________________________________ Telephone Number:(____) _____________________________ Fax Number: (____) _____________________________ E-Mail Address: ____________________________________
Section 3: Questionnaire (To be completed by Contract Reference POC when CPARS not available)
1. Conformance of delivered modular to Contract Requirements:
☐Good ☐Acceptable ☐Marginal ☐Unacceptable ☐Not Applicable
2. Quality of delivered modular:
☐Good ☐Acceptable ☐Marginal ☐Unacceptable ☐Not Applicable
3. On-Time Delivery of modular (ability to meet required delivery dates):
☐Good ☐Acceptable ☐Marginal ☐Unacceptable ☐Not Applicable
4. Overall Customer Service provided:
☐Good ☐Acceptable ☐Marginal ☐Unacceptable ☐Not Applicable
5. Quality of Technical Support provided:
☐Good ☐Acceptable ☐Marginal ☐Unacceptable ☐Not Applicable
6. Response to Warranty Claims:
☐Good ☐Acceptable ☐Marginal ☐Unacceptable ☐Not Applicable
Additional Comments:
Click or tap here to enter text.
Contract Reference POC’s Contact Information:
First and Last Name:
Title:
Organization or Company Name:
Phone Number: E-mail Address:
Today’s date:
Please e-mail this completed form directly to Bridgette Clayton at bridgette.l.clayton.civ@us.navy.mil and Jessie Rehwoldt at jessie.m.rehwoldt.civ@us.navy.mil
If you have any questions about this form, please contact:
Bridgette Clayton Contract Specialist bridgette.l.clayton.civ@us.navy.mil
File details come from the government source that posted it. Updated .