Attachment_5_Forms_to_Return_with_Quote.docx
DOCX document 34 KB Posted
- Attached to
- OLYMPIC MAYFIELD HOUSE FIRE SPRINKLER SYSTEM Federal contract opportunity
- Solicitation number
- 140P8326Q0007
About this file
This is a forms attachment document for a federal solicitation requesting quotes for installing a fire sprinkler system at Mayfield House. Quoters must submit a lump sum price covering all labor, tools, equipment, materials, mobilization, insurance, contract administration, project management, overhead, and profit. The work must comply with Davis-Bacon Act wage rates and project specifications outlined in the Statement of Work. The Department of the Interior National Park Service Pacific West Region will award the contract to one contractor based on evaluation criteria in Sections L and M of the solicitation (Solicitation No. 140P8326Q0007).
The document requires quoters to submit three to five relevant projects completed within the past five years, demonstrating experience with similar construction work. Quoters must provide detailed information about each project including the owner's contact information, project location, value, and construction dates, along with descriptions of their scope of work and performance remarks. The form also includes a technical approach section requiring quoters to describe their work plan, staffing by job classification, schedule, phasing, and equipment—with simple restatements of SOW requirements deemed ineligible. Additionally, quoters must complete representations regarding covered telecommunications equipment or services in compliance with Section 889 of the John S. McCain National Defense Authorization Act, including disclosure of any such equipment or services they will provide or use in performance of the contract.
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PRICE SCHEDULE
The contractor shall factor the lump sum price to include all labor, tools, equipment, materials, mobilization-in, mobilization-out, insurance, contract administration, project management, overhead and profit (applicable to prime contractor and any subcontractors) necessary for completing all work. All work shall be performed in accordance with the awarded contract terms and clauses, including the attached Dept. of Labor Davis-Bacon Act wage rates and project specifications delineated in the Statement of Work (SOW).
The Quoter shall submit a price for the line item below. Failure to do so may render the quote ineligible. For the priced line item, provide the total price only. Round totals to whole dollars. Award will be made to one contractor in accordance with Sections L and M.
Complete this page and return with other documents described in Section L.
| Price Schedule - Line-Item Number |
| Description |
| Qty |
| Unit of Measure |
| Total Price |
| 1 |
| Install Sprinkler System at Mayfield House |
| 1 |
| Lump Sum |
| $ |
| TOTAL PRICE: |
| $ |
Business Name:
Address:
SAM UEI:
Phone:
Submitted by – Printed Name:
Submitted by – Signature:
Date:
Solicitation no. 140P8326Q0007– Attachment no. 5, Forms to Return with Quote
Relevant Experience #1 READ CAREFULLY: The purpose of this form is for the quoter to list construction projects (preferably performed during the past five (5) years) that are similar to the work described in this solicitation and from whom the government may gather past performance information. The number of projects listed shall be three (3) at minimum and not to exceed five (5) maximum and shall be numbered consecutively, beginning with the most recent project. Use this form to address your familiarity with the Scope of Work described in the plans and specifications and with the capability criteria described in the Request for Quote. Include area codes with all telephone numbers. Type or print legibly. Use more space if necessary.
The Government may contact the entities listed herein to obtain past performance reviews of the quoter’s team. Past performance is a measure of the degree to which the Quoter satisfied its customers in the past and complied with federal, state, and local laws and regulations. The past performance of the quoter, key personnel (if applicable), and proposed subcontractors on projects similar in scope and complexity (i.e. relevant to the current project) will be evaluated in the areas of quality, timeliness, and business relations. It is especially important that the quoter disclose instances in which their past performance may be considered by others to be less than fully satisfactory. The quoter should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that a quoter has been less than candid with the Government, which could result in an unfavorable assessment of the quoter’s past performance record.
Name of Quoter:
Project Name:
Project Location:
Contract # (if known):
Agency/Owner:
Email Address of Owner:
Phone Number of Owner:
Project Value:
Dates of Construction:
DESCRIPTION OF THE PROJECT AND SCOPE FOR QUOTER’S WORK
PERFORMANCE REMARKS
Relevant Experience #2 READ CAREFULLY: The purpose of this form is for the quoter to list construction projects (preferably performed during the past five (5) years) that are similar to the work described in this solicitation and from whom the government may gather past performance information. The number of projects listed shall be three (3) at minimum and not to exceed five (5) maximum and shall be numbered consecutively, beginning with the most recent project. Use this form to address your familiarity with the Scope of Work described in the plans and specifications and with the capability criteria described in the Request for Quote. Include area codes with all telephone numbers. Type or print legibly. Use more space if necessary.
The Government may contact the entities listed herein to obtain past performance reviews of the quoter’s team. Past performance is a measure of the degree to which the Quoter satisfied its customers in the past and complied with federal, state, and local laws and regulations. The past performance of the quoter, key personnel (if applicable), and proposed subcontractors on projects similar in scope and complexity (i.e. relevant to the current project) will be evaluated in the areas of quality, timeliness, and business relations. It is especially important that the quoter disclose instances in which their past performance may be considered by others to be less than fully satisfactory. The quoter should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that a quoter has been less than candid with the Government, which could result in an unfavorable assessment of the quoter’s past performance record.
Name of Quoter:
Project Name:
Project Location:
Contract # (if known):
Agency/Owner:
Email Address of Owner:
Phone Number of Owner:
Project Value:
Relevant Experience #3 READ CAREFULLY: The purpose of this form is for the quoter to list construction projects (preferably performed during the past five (5) years) that are similar to the work described in this solicitation and from whom the government may gather past performance information. The number of projects listed shall be three (3) at minimum and not to exceed five (5) maximum and shall be numbered consecutively, beginning with the most recent project. Use this form to address your familiarity with the Scope of Work described in the plans and specifications and with the capability criteria described in the Request for Quote. Include area codes with all telephone numbers. Type or print legibly. Use more space if necessary.
The Government may contact the entities listed herein to obtain past performance reviews of the quoter’s team. Past performance is a measure of the degree to which the Quoter satisfied its customers in the past and complied with federal, state, and local laws and regulations. The past performance of the quoter, key personnel (if applicable), and proposed subcontractors on projects similar in scope and complexity (i.e. relevant to the current project) will be evaluated in the areas of quality, timeliness, and business relations. It is especially important that the quoter disclose instances in which their past performance may be considered by others to be less than fully satisfactory. The quoter should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that a quoter has been less than candid with the Government, which could result in an unfavorable assessment of the quoter’s past performance record.
Name of Quoter:
Project Name:
Project Location:
Contract # (if known):
Agency/Owner:
Email Address of Owner:
Phone Number of Owner:
Project Value:
Technical Approach Provide a brief work plan describing your approach to the project that demonstrates your understanding of the requirements and the capabilities and experience you bring to it. Include, for example, number of workers (by job classification) and tentative work schedule, phasing the work, equipment you expect to use. PLEASE NOTE: A simple restatement of the requirements outlined in the SOW is not acceptable and may render the quote ineligible.
K.2 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (NOV 2021)
This section requires contractor to fill in and submit with quote unless the offeror has already responded “does not” in Paragraphs (c)(1) and (c)(2) of 52.204–26, Covered Telecommunications Equipment or Services—Representation (OCT 2020) in SAM. Quoter shall refer to Attachment no. 3, “Forms to Submit with Quote” to fill in this provision.
The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26, Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Products or Commercial Services. The Offeror shall not complete the representation in paragraph (d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.
(a) Definitions. As used in this provision— Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements, reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.
(b) Prohibition.
| (1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year | 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2019, | from procuring or obtaining, or extending or renewing a contract to procure or obtain, any | equipment, system, or service that uses covered telecommunications equipment or services as a | substantial or essential component of any system, or as critical technology as part of any system. | Nothing in the prohibition shall be construed to— | |||||||
| (i) Prohibit the head of an executive agency from procuring with an entity to provide a | service that connects to the facilities of a third-party, such as backhaul, roaming, or | interconnection arrangements; or | ||||||||||
| (ii) Cover telecommunications equipment that cannot route or redirect user data traffic | or cannot permit visibility into any user data or packets that such | equipment transmits or otherwise handles. | ||||||||||
| (2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year | 2019 (Pub. L. 115-232) prohibits the head of an executive agency on or after August 13, 2020, from | entering into a contract | or extending or renewing a contract with an entity that uses any equipment, | system, or service that uses covered | telecommunications equipment or services as a substantial or | essential component of any system, or as critical | technology as part of any system. This | prohibition applies to the use of covered telecommunications equipment or | services, regardless of | whether that use is in performance of work under a Federal contract. Nothing in the prohibition | shall be construed to— | |
| (i) Prohibit the head of an executive agency from procuring with an entity to provide a | service that | connects to the facilities of a third-party, such as backhaul, roaming, or | interconnection arrangements; or | |||||||||
| (ii) Cover telecommunications equipment that cannot route or redirect user data traffic | or cannot permit visibility into any user data or packets that such equipment transmits | or otherwise handles. |
(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM) ( https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".
(d) Representation. The Offeror represents that—
| (1) It □ will, □ will not provide covered telecommunications equipment or services to the | Government in the performance of any contract, subcontract or other contractual instrument | resulting from this solicitation. The Offeror shall provide the additional disclosure information | required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this | section; and | ||
| (2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents | that— | |||||
| It □ does, □ does not use covered telecommunications equipment or services, or use any | equipment, system, or service that uses covered telecommunications equipment or services. The | Offeror shall provide the additional | disclosure information required at paragraph (e)(2) of this | section if the Offeror responds "does" in paragraph | (d)(2) of this section. |
(e) Disclosures.
(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer:
(i) For covered equipment—
| (A) The entity that produced the covered telecommunications equipment (include | entity name, unique entity identifier, CAGE code, and whether the entity was the | original equipment manufacturer (OEM) or a distributor, if known); | |
| (B) A description of all covered telecommunications equipment offered (include | brand; model number, such as OEM number, manufacturer part number, or | wholesaler number; and item description, as applicable); and | |
| (C) Explanation of the proposed use of covered telecommunications equipment | and any factors relevant to determining if such use would be permissible under | the prohibition in paragraph (b)(1) of this provision. |
(ii) For covered services—
| (A) If the service is related to item maintenance: A description of all covered | telecommunications services offered (include on the item being maintained: | Brand; model number, such as OEM number, manufacturer part number, or | wholesaler number; and item description, as applicable); | or | ||||
| (B) If not associated with maintenance, the Product Service Code (PSC) of the | service being provided; and explanation of the proposed use of covered | telecommunications services and any factors relevant to determining if such use | would be permissible under the prohibition in paragraph (b)(1) of this provision. | |||||
| (2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has | responded "does" in the representation in paragraph (d)(2) of this provision, the Offeror shall | provide the following information as part | of the offer: |
(i) For covered equipment—
| (A) The entity that produced the covered telecommunications equipment (include | entity name, unique entity identifier, CAGE code, and whether the entity was the | OEM or a distributor, if known); | ||
| (B) A description of all covered telecommunications equipment offered (include | brand; model number, such as OEM number, manufacturer part number, or | wholesaler number; and item description, as applicable); and | ||
| (C) Explanation of the proposed use of covered telecommunications equipment | and any factors relevant to determining if such use would be permissible under | the prohibition in paragraph (b)(2) of this provision. |
(ii) For covered services—
| (A) If the service is related to item maintenance: A description of all covered | telecommunications services offered (include on the item being maintained: | Brand; model number, such as OEM number, manufacturer part number, or | wholesaler number; and item description, as applicable); | or |
| (B) If not associated with maintenance, the PSC of the service being provided; | and explanation of the proposed use of covered telecommunications services and | any factors relevant to determining if such use would be permissible under the | prohibition in paragraph (b)(2) of this provision. |
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