Attachment 3_Experience and PPQ.pdf

RFP N4008420R0409

TECHNICAL PROPOSAL FOR

RFP NO. N4008420R0409

Preventive Maintenance and Service Orders for Heating Ventilating Air

Conditioning (HVAC) Systems at Various Locations Japan

(U.S. Naval Installations in KANTO Plain)

(COMPLETE AND SUBMIT WITH YOUR PROPOSAL)

COMPANY NAME:

REPRESENTATIVE NAME AND TITLE:

COMPANY PHONE/FAX NO.

DUNS NUMBER/CAGE NUMBER

ATTACHMENT A EXPERIENCE

The offeror shall complete all sections in English.

EXPERIENCE PROJECT DATA SHEET

#1

CORPORATE EXPERIENCE PROJECT DATA SHEET

Project No. (check one) : #1 #2 #3 #4 #5

1. Experience for: Offeror Joint-Venture Other (Explain)

Firm Name:

Address:

Phone Number:

Point of Contact: Contact Phone Number:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other

(Explain)

Percent of project work performed:

If subcontractor, who was prime (Name/Phone #):

3. Contract Number: Delivery/Task Order Number:

Title:

Location:

4. Award Date (mm/dd/yy): Completion Date (mm/dd/yy):

5. Type of work:

Maintenance Repair Alteration Other (explain):

6. Type of Contract/Task Order: (Check ALL that apply)

Firm-Fixed Price Cost/Time and Material Other (explain):

7. Award Amount: Final Price:

8. Provide a detailed description of the project and the relevancy to the project requirements of this RFP (Include applicable annex in accordance with Factor 1)

9. Provide a detailed description of what work your firm self-performed on this project:

10. Other Information:

NOTE: NAVFAC REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE

AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE

COMPLETED QUESTIONNAIRE TO NAVFAC WITH THEIR PROPOSAL, AND MAY

DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON NAVFAC

SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES

DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY BE SUBMITTED

DIRECTLY TO NAVFAC. PLEASE CONTACT THE OFFEROR FOR NAVFAC POC

INFORMATION. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL

INFORMATION ON THIS FORM.

FACTOR 2 - SAFETY NARRATIVE

Use this form to provide the Safety Narrative. Individual blocks on this form may be expanded; however, total length shall not exceed 2 single-sided (1 double sided) pages. Additional pages will not be considered.

OFFEROR NAME:

1. Describe the Offeror’s methodology for selecting a subcontractor with a safe performance record:

2. Describe the Offeror’s plan to monitor and oversee the safety compliance and performance of self-performed and subcontractor performed work:

3. Describe the Offeror’s methodology to execute an effective program that facilitates accident prevention techniques and processes and employee reporting of unsafe conditions and unsafe activities:

4. Other relevant information:

1. The NAVFAC Form PPQ shall be utilized for all evaluations that require a Past Performance

Questionnaire (PPQ).

2. Solicitations utilizing PPQs shall include the language cited below in the RFP. The current

NAVFAC Form PPQ-0 is available in BMS S-17.2.15 Source Selection.

“Solicitation Submittal Requirements: IF A COMPLETED CPARS EVALUATION IS AVAILABLE, IT SHALL BE SUBMITTED WITH THE PROPOSAL. IF THERE IS NOT A COMPLETED CPARS

EVALUATION, the Past Performance Questionnaire (PPQ) included in the solicitation is provided for the offeror or its team members to submit to the client for each project the offeror includes in its proposal for Factor 1, Corporate Experience. AN OFFEROR SHALL NOT SUBMIT A PPQ WHEN A

COMPLETED CPARS IS AVAILABLE.

IF A CPARS EVALUATION IS NOT AVAILABLE, ensure correct phone numbers and email addresses are provided for the client point of contact. Completed PPQs should be submitted with your proposal. If the offeror is unable to obtain a completed PPQ from a client for a project(s) before proposal closing date, the offeror should complete and submit with the proposal the first page of the PPQ (Attachment E ), which will provide contract and client information for the respective project(s). Offerors should follow-up with clients/references to ensure timely submittal of questionnaires. If the client requests, questionnaires may be submitted directly to the Government's point of contact, Ms. Maria Callo, via email at maria.callo@fe.navy.mil prior to proposal closing date. Offerors shall not incorporate by reference into their proposal PPQs or CPARS previously submitted for other RFPs. However, this does not preclude the Government from utilizing previously submitted PPQ information in the past performance evaluation.”

ATTACHMENT E

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information

Firm Name: CAGE Code:

Address: Entity Identifier Number:

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other

(Explain)

Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

mailto:junko.miyachi.ja@fe.navy.mil

3. Contract Information

Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: Firm Fixed Price Cost Reimbursement Other (Please specify):

Contract Title:

Contract Location:

Award Date (mm/dd/yy):

Contract Completion Date (mm/dd/yy):

Actual Completion Date (mm/dd/yy):

Explain Differences:

Original Contract Price (Award Amount):

Final Contract Price (to include all modifications, if applicable):

Explain Differences:

4. Project Description:

Complexity of Work High Med Routine

How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

CLIENT INFORMATION (Client to complete Blocks 5-8)

5. Client Information

Name:

Title:

Phone Number:

Email Address:

6. Describe the client’s role in the project:

7. Date Questionnaire was completed (mm/dd/yy):

8. Client’s Signature:

NOTE: NAVFAC REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE

AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE

COMPLETED QUESTIONNAIRE TO NAVFAC WITH THEIR PROPOSAL, AND MAY

DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON NAVFAC

SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT

QUESTIONNAIRES DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY

BE SUBMITTED DIRECTLY TO NAVFAC. PLEASE CONTACT THE OFFEROR FOR

NAVFAC POC INFORMATION. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY

ANY AND ALL INFORMATION ON THIS FORM.