EXHIBIT A.doc

Case Management Services Florida Army National Guard

W911YN-20-R-0005

EXHIBIT A PERFORMANCE RELEVANCY QUESTIONNAIRE

PART 1: Prepare questionnaires in the format provided.

Provide the following information requested in this format for each of the projects/contracts being described. Prepare not more than three (3) of these documents. Contractors should select their projects carefully because the quality of the contractor’s relevant performance is more important than the quantity of projects submitted. Projects may be on going, if complete to 70 %, and cannot have been completed any earlier than 3 years prior to the solicitation issue date. Provide frank, concise comments regarding your performance on the contracts you identify. Use as much space as required.

A. Offeror (Your) Name (Company/Division):

B. Project/Contract Title:

C. Contract Specifics:

1. Description of Effort as ___________Prime or _________Subcontractor

2. Contract Number

3. Original Contract $ Value _____________ Current/Final Contract $ Value ____________

4. If amounts in 3 above are different, provide a brief description of the reason:

5. Completion Date:

1. Original Date: ______________

2. Current Schedule____________________

3. Estimated/Final Completion Date:________________________________

4. Primary cause for Contract Modifications__________________________________

D. Provide detailed description of the work performed under the contract including, but not limited to your past performance. Note that your description will be evaluated for similarity of project, particularly project scope; cost magnitude, and complexity of work performed to those required for the proposed effort. The Government may also consider similarity of the client type (i.e. federal government) and/or the project sustainability requirements. The location at which work was performed to the location(s) at which work will be performed may also be considered.

1. Describe the specific elements of the work performed by your firm.

2. Indicate what elements of work were performed by your major subcontractors and if those same subcontractors will be used on this project. If you intend to use these subcontractors, please list name and principal areas of work they will perform. Indicate if you do not intend on utilizing any of these subcontractors.

3. If you intend to use any of the same key personnel on this solicitation’s project, indicate by name and position those personnel proposed to be utilized on the referenced contract. (Project Manager, Site Superintendent, Quality Control Manager). Indicate what position they will have on this solicitation’s contract. Indicate if you do not intend on utilizing any of these same personnel.

4. Describe why you believe the work is very relevant, relevant or semi-relevant to this solicited project. (Use as much space as necessary)

E. List a point of Contact for Owner/Government agency Contracting Officer and/or inspector; include a current phone number and facsimile number. Email address is also desired. (This information is required here even though you will be sending Exhibit C letters and questionnaires to these references. (Do NOT include a copy of the Exhibit Cs you sent to your references.)

End of Part 1 - Questionnaire Requirements – Prepare and send Exhibit C Package to the reference(s) for each of projects discussed in the Exhibit As.

PART 2: Provide the following information one time.

Additional offeror information required, but not project specific. This information need only be provided once in your submission package.

2 A. Applicable to all offerors - Describe your compliance with the requirements of FAR clause 52.219-8 Utilization of Small Business Concerns. Even if you are a Small or Small Disadvantaged Business, this clause in Federal Contracts applies. It is the policy of the United States that small business concerns, veteran-owned small business concerns, service-disabled veteran-owned small business concerns, HUBZone small business concerns, small disadvantaged business concerns, and women-owned small business concerns shall have the maximum practicable opportunity to participate in performing contracts let by any Federal agency, including contracts and subcontracts for subsystems, assemblies, components, and related services for major systems. It is also policy to establish procedures to ensure the timely payment of amounts due pursuant to the terms of their subcontracts. Describe below the methods you have used to comply with this policy on prior federal contracts. Include any evidence, or a point of contact to verify this information, if available.

2B: Offerors are strongly encouraged to include with their proposals information on problems encountered on relevant projects and the specific corrective actions taken to remedy the problem(s).

2C: List any projects within the last five (5) years that have been terminated, for any reason. Provide an explanation. If none, make a positive statement to that effect.

2D Compliance with Safety Standards. Provide proof of your Experience Modification Rate (EMR).

End of Questionnaire Requirements