_Exhibit C. Reference Questionnaire Package_W50S6X-23-R-0006 Asphalt Paving.docx

Solicitation W50S6X-23-R-0006 FY23 TITLE OF PROJECT: Delaware Air National Guard Asphalt Paving Repair (JLWS202068)

EXHIBIT C

PAST PERFORMANCE REFERENCE QUESTIONNAIRE

Instructions to Offeror for sending Reference Questionnaire Forms:

Prepare and submit to the owners of the projects listed in your Exhibit A “Performance Relevancy Questionnaires,” a Past Performance Reference Questionnaire (Exhibit C). For Government contracts, send to the respective Contracting Officer. For commercial references, send to person with duties similar to those for Government contracts. Offerors should follow-up and encourage references to return completed questionnaires in a timely manner. If you have multiple references at one location (i.e., at a military base), send one cover letter and questionnaires for each contract for which you need a reference. Your questionnaire package should contain the following:

· Cover Letter (See SAMPLE on the next page)

· Respondent Info Rating Sheets (Exhibit C). Offeror should put name in spaces indicated and ensure it is on every page for identification purposes.

OFFEROR SHOULD PLACE THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE

In accordance with Section 00 21 00 – Proposal Evaluations and Basis for Award, completed questionnaires should be sent directly to the Contracting Office.

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

SAMPLE PERFORMANCE ASSESSMENT QUESTIONNAIRE – COVER LETTER

(Insert Company Letterhead)

USPFO-DE / ARNG

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal

(RFP) W50S6X-23-R-0006

Dear Sir/Ma’am, The Delaware National Guard is currently conducting a competitive source selection to evaluate Offerors on the subject RFP. As part of this evaluation, we have requested that the Offerors provide information about their past performance on recent and relevant federal, state, or local government or commercial contracts as compared to the North American Industry Classification System (NAICS) 237310 Highway, Street, and Bridge Construction. You have been identified as the point of contact cited on the enclosure.

Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return to the U.S. Property & Fiscal Office for Delaware, Purchasing & Contracting Branch, no later than 15 days after receipt of request or (insert date), whichever occurs first. Submit your completed questionnaire to Joseph.Scarpa6.civ@army.mil, copy to Amy.L.Kline.civ@army.mil.

Your cooperation is greatly appreciated. Questions may be directed to Joseph Scarpa at Joseph.Scarpa6.civ@army.mil.

Sincerely, Amy Kline Contracting Officer

Performance Assessment Questionnaire

Please provide your candid responses. The information that you provide will be used in the awarding of federal contracts. Therefore, it is important that your information be as factual, accurate and complete as possible to preclude the need for follow-up by the evaluators. If you do not have knowledge of or experience with the company in question, please forward this Questionnaire to the person who does and/or notify Joseph.Scarpa6.CIV@army.mil, copy to Amy.L.Kline.CIV@army.mil via email. Please return the completed Questionnaire to the Contracting Officer identified in the cover letter within the stated timeframe.

Rating Definitions:

Substantial Confidence: Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective. The offeror has been highly successfully in performing the required effort.

Satisfactory Confidence: Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective. The offeror has successfully performed the required effort.

Limited Confidence: Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective. The offeror has had little success performing the required effort.

No Confidence: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective. The offeror has not successfully performed the required effort.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

Total Contract Value:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent) *Note: rationale is required for each response.

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

· Substantial Confidence

· Satisfactory Confidence

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

B. Effectiveness of Project Management (to include use and control of subcontractors).

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

C. Timeliness of Performance for Services and Product Deliverables.

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

D. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

· Limited Confidence

· No Confidence

Rationale: __________________________________________________________

E. General Comments. Provide any other relevant performance information.

Comments: _________________________________________________________

F. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

Point of Contact (Name): __________________________________________ Telephone Number: ______________________________________________

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire to the Contracting Officer identified in the cover letter.

Thank you for your assistance.