Attachment J10 Past Performance Questionnaire.pdf
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- Solicitation number
- N4008521R0149
About this file
This document includes an attachment for a past performance questionnaire and details of a federal contract opportunity solicitation. The solicitation is for an Indefinite Delivery Indefinite Quantity Remedial Action Operation Multiple Award Contract for environmental services in the Hampton Roads, Virginia area. The Naval Facilities Engineering Command Mid-Atlantic will award up to five basic contracts with a total maximum value of $30 million over all years and contracts. Individual task orders will range from $50,000 to $250,000. The NAICS code is 562910 for environmental remediation services. This is a 100% small business set-aside for firms in the Eastern United States. The contract aims to obtain services for operation and maintenance of environmental remedies and long-term monitoring at various sites. Performance will be in accordance with written task orders and involve assessing remedial action effectiveness by measuring chemicals and their environmental impacts. Typical remedial actions may include soil and groundwater containment and treatment systems.
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Remedial Action Operation Multiple N40085-21-R-0149 Award Contract (RAOMAC) for Environmental Services Naval Facilities Engineering Command, Mid-Atlantic
ATTACHMENT J10
NAVFAC PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)
CONTRACT INFORMATION (Contractor to complete Blocks 1-4)
1. Contractor Information Firm Name: CAGE Code:
Address: DUNs 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 #):
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.
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