EXHIBIT B - Past Performance Relevancy Questionnaire Tomo.pdf

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C1DZ--Design Build Project for Radiation Therapy Tomotherapy Upgrade at VAPHS University Drive
Solicitation number
36C24420R0066
Issued by

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This exhibit is a past performance questionnaire for a design-build project for a radiation therapy tomotherapy upgrade at a Veterans Affairs medical center. Offerors must provide details on up to three relevant past projects as prime or subcontractor, including contract specifics, work descriptions, and points of contact. Subcontractors for various construction disciplines must also be identified if to be used on this project. The Department of Veterans Affairs Veterans Health Administration VISN 4 is soliciting proposals for a single firm-fixed-price contract to be awarded based on evaluation of Phase I responses and price in a best value determination. Phase II submission instructions will be provided to offerors selected from the Phase I evaluation to further compete for the work.

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EXHIBIT B PERFORMANCE RELEVANCY QUESTIONNAIRE

PART 1: Prepare no more than three (3) Part 1 forms: (Phase I).

Provide the following information requested in this format for each of the projects/contracts being described. Projects may be on going and cannot have been completed any later than five

(5) years prior to the solicitation issue date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you identify. no more than (3) pages per project.

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:

6. Original Date:

7. Current Schedule:

8. Estimate/Final Completion Date:

EXHIBIT B PERFORMANCE RELEVANCY QUESTIONNAIRE

9. Primary cause for Contract Modifications:

D. Provide detailed description of the work performed under the contract and describe why you believe the work is very relevant, relevant or semi-relevant to this solicited project. (Use as much space as necessary)

In addition, address the following:

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 indicate if those same subcontractors will be used on this project. Should you intend to use these same subcontractors, please list their company names and described their principal areas of work that they will perform.

3. Address any technical areas about this project you consider uniquely relevant to this solicitation.

E. Point of Contact for Owner/Government agency Contracting Officer and or inspector (COR);

include a current phone number and email address for each.

End of Part 1- Questionnaire Requirements – Prepare and send Exhibit C Package to the reference(s) for each of the no more than three Construction Projects, or Specialty Trade if applicable provided in Exhibit A, Part 1. See below for Exhibit A, Part 2.

Part 2, Additional offeror information required.

A. Name subcontractors and/or Teaming Partners to be utilized on this contract. Multiple subcontractors may be named for the same discipline but are limited to a maximum of three

(3) subcontractors per discipline. As a minimum, provide the name(s) of subcontractors to be utilized in the following areas:

(Specialty Trades will address their specific trade for any major subcontractor or Teaming partner – list below is not all inclusive or may not apply)

a. Specialty Trades:

i. Existing Conditions

ii. Concrete

iii. Masonry

iv. Metals

v. Wood, Plastics and Composites

vi. Thermal and Moisture Protection

vii. Openings

viii. Finishes

ix. Specialties

x. Equipment

xi. Furnishings

xii. Conveying Equipment

xiii. Fire Suppression

xiv. Plumbing

xv. Heating, Ventilating and Air Conditioning

xvi. Electrical

xvii. Electrical Safety and Security

xviii. Earthworks

xix. Exterior Improvements

xx. Utilities

{MUST BE PROJECT SPECIFIC}

PART 1: Prepare no more than three (3) Part 1 forms: (Phase I).
End of Part 1- Questionnaire Requirements – Prepare and send Exhibit C Package to the reference(s) for each of the no more than three Construction Projects, or Specialty Trade if applicable provided in Exhibit A, Part 1. See below for Exhibit A, Part ...

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