Attachment G - Responsibility Determination Questionnaire.pdf

ATTACHMENT G

RESPONSIBILITY DETERMINATION QUESTIONNAIRE

Directorate of Contracting

Dear Offeror:

As required by the Federal Acquisition Regulation (FAR) part 9 Contractor Qualifications, and Defense Federal Acquisition Regulation Supplement (DFARS) part 209, the Contracting Officer is conducting a responsibility determination and requires information from your firm as outlined below.

Information Regarding Responsibility

Determinations of responsibility involve subjective business judgments that are within the broad discretion of the contracting agency. The Contracting Officer is vested with broad discretion in exercising the business judgment involved in a responsibility determination.

This Questionnaire is not an additional non-pricing factor; the information requested below pertains to the offeror’s ability to perform the contract (if awarded) rather than the acceptability of the offer presented. Your responses to this Questionnaire will assist the Contracting Officer in making their responsibility determination. It is the duty of the offeror to supply all necessary documentation to establish its responsibility.

While this Questionnaire uses the term “offeror,” know that when determining an offeror’s responsibility, the Contracting Officer is required by the FAR to look at entities with relationships to the offeror, including (but not limited to) affiliates, subsidiaries, principals, and key personnel. As a result, in some cases, this Questionnaire seeks information regarding individuals that are connected to the offeror (generally key personnel, principals, etc.) as well as information regarding the offeror’s corporate relationships (generally affiliated concerns, subsidiaries, etc.). See FAR 19.001 and

19.101 for definitions regarding affiliated concerns; and see FAR 52.209-5 -- Certification Regarding Responsibility Matters for definitions regarding offeror principals.

If the offeror is proposing as a Joint Venture (JV), each member of the JV shall respond to this questionnaire independently.

When responding to questions that have a fixed time period (e.g. a question that requests information related to any event “in the past five years”) calculate the time period duration from the date that you submit your response to this Questionnaire.

Be advised that this Questionnaire, or any follow up communication by the Agency regarding your response to this Questionnaire, does not constitute discussions, negotiations, or clarifications, as contemplated in FAR part 15.

The documentation requirements in this Questionnaire regarding page limitation, etc… apply to your response to this request, unless otherwise noted. Please be advised that all, or portions of your response, to this request for information may be incorporated into the awarded contract, should award be made to your firm.

The Contracting Officer is not limited to your responses in making a responsibility determination. The Contracting Officer must determine a prospective contractor non-responsible in the absence of adequate and timely information clearly indicating the contractor is responsible. Your inability or unwillingness to provide this information will be considered in making this responsibility determination, and may result in a finding of non-responsibility.

Information Upon Which The Responsibility Determination Will Be Based

To facilitate the Contracting Officer’s responsibility determination, please:

a) Complete and return:

1) Endorsement A (Financial Standing Questionnaire) and

b) Provide a narrative (not exceeding two pages) that states:

1) the offeror’s current credit rating;

2) evidence of the offeror’s financial resources (or to obtain such resources) to successfully perform the contract, considering all other outstanding obligations of the offeror; and

3) whether the offeror has ever petitioned a government body to have its debts restructured, forgiven, liquidated, or otherwise dispatched in an insolvency proceeding (e.g. filed for bankruptcy, or non-U.S. equivalent, including “liquidation” or “administration”), in any jurisdiction, at any time in the past five years, regardless of the ultimate resolution.

If the answer is in the affirmative relative to the filing of an insolvency proceeding, identify:

1) the country where the matter was filed;

2) the court or forum in which it was filed;

3) the assigned case number;

4) the date of filing;

5) when matter was resolved; and

6) how it was resolved.

c) Provide a narrative (which does not exceed five pages) regarding the offeror’s record of integrity and business ethics. At a minimum, your narrative must address:

1) whether at any time in the past five years, the offeror has any subcontractors or suppliers that have been unpaid for a duration longer than the time required by the contract for payment. If the answer is in the affirmative, explain why payments to subcontractors or suppliers exceed the contractually allowed for payment timeline;

2) whether the offeror has ever been contacted by a Contracting Officer, Administrative Contracting Officer, Contracting Officer’s Representative, or any other U.S. Government employee, regarding any Combating Trafficking in Persons (CTIP) concern. In your response, identify the issue, the resolution, and the contract number;

3) whether there have been any criminal convictions, in the last five years, of any of the offeror’s principals, owners, officers, any individuals identified as a Key Personnel in response to a non-pricing factor, or any person with any contractual authority on the resultant contract, if awarded; and

4) any findings or citations by a judicial body or regulatory entity that the offeror has committed a violation of law or regulation, in any jurisdiction, regardless of resolution, in the last 5 years.

d) Provide the names and DUNS numbers (if any) of all of the offeror’s current owners, predecessors (within last 3 years), subsidiaries, and affiliated concerns that will be used in the performance of the resultant contract, if awarded. This is in accordance with FAR 52.209-5 -- Certification Regarding Responsibility Matters.

e) Provide the first and last name (and middle initial, if applicable) and job title of:

1) all of the offeror’s principals;

2) any person identified as a key personnel in response to any non-pricing evaluation criteria, if such is required; and

3) any person with any contractual authority on the resultant contract, if awarded.

f) The Offeror shall provide a copy of a valid Jordan Commercial Registration Certificate (business license) in the offeror’s name for which it is submitting a proposal (as required by DFARS 252.225-7042 Authorization to Perform). If the name on the certificate does not match the name in which the proposal is submitted, the offeror shall submit documentation explaining the reason for the discrepancy and proof of the offeror’s legal ability to operate under the certificate. If the offeror has a business license that will expire on or before May 18, 2021, the estimated date of award, the questionnaire shall include the offeror’s supported plan to extend and/or renew the certificate. A descriptive narrative, if required, shall be limited to no more than two (2) pages.

g) The offeror shall designate an individual to be responsible for CTIP compliance and a CTIP compliance plan implementation that complies with FAR Clause 52.222-

50. The designated position shall have the necessary authority to ensure compliance at all levels of the company and throughout the supply chain, and be able to ensure the accuracy of its certification to the Government. Additionally, the offeror shall submit a certification regarding trafficking in persons compliance in accordance with FAR Clause 52.222-56 paragraph (c).

Submission Requirements:

Please complete the above requested information as Volume III. In your response, please identify which documents are responsive to which subpart; however the Contracting Officer is not limited to your identification and may use any submitted document in response to any subpart as (s)he deems appropriate.

The Contracting Officer may require that some or all of these responses be updated in advance of award, should your firm be chosen for award.

The Responsibility Determination Questionnaire, Volume III, must be submitted electronically with your proposal submission.

Endorsement:

A - Financial Standing Questionnaire

ENDORSEMENT A

FINANCIAL STANDING QUESTIONNAIRE

A primary consideration in the source selection process is to determine an offeror’s qualification, responsibility, and financial standing. Prior to awarding a contract, per Federal Acquisition Regulation (FAR) Part 9, the Government must determine, through acceptable evidence, that an offeror has adequate financial resources, or the ability to obtain the financial resources, to perform the contract. The substantive answers in Attachment A are to be completed by the offeror’s financial institution. Offerors should obtain a bank stamp or seal AND signature of the referenced individual on the questionnaire. Failure to provide the requested information may render an offeror’s proposal non-responsible, and cause it to be removed from competition.

GENERAL INFORMATION (to be completed by the contractor):

Contractor’s Name and address:

Point of Contact:

Telephone:

Email:

Solicitation number:

RESPONDENT INFORMATION (to be completed by an authorized Financial Institution representative):

Full Name and Title:

Name of Financial Institution:

Address:

Telephone/Fax:

Email address:

1. Does the contractor have an active account(s) with your financial institution? If yes, how many?

2. How long have the account(s) been active?

3. What are the account(s) average balance (digits only)?

4. How many returns (insufficient funds) has the contractor had in the last 12 months?

5. Does the contractor currently have outstanding loans? If yes, a) how many; b) what are the balances due on those loans (digits only); and c) is the contractor making payments in accordance with the terms of the loans?

6. In the last 12 months, has the contractor been able to meet its financial obligations on time?

7. Does the contractor have a line of credit? If so, a) what is the credit limit (digits only);

and b) how much credit is presently available for use (digits only)?

If you need additional space to respond, please indicate that additional documentation was provided in response your above answers.

Certificate of Authority

I, ______________________ certify that as ______________________ of (Insert name) (Insert job title)

______________________ I am duly authorized to execute this form.

(Insert corporation name)

Signature _______________________________________ Date ___________

(Financial Institution Seal/Stamp)