EXHIBIT_C_-_Reference_Questionnaire_Package NEW Ld.docx

Solicitation W912LM-20-R-1003 FY20 Renovate B222 for LRS

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 Contracting Specialist at MN USPFO Camp Ripley Bldg 15-2 15000 Hwy 115 Little Falls MN 56345. For commercial references, send to personnel 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) (the following 4 pages). Offeror should put name in spaces indicated and ensure it is on every page for identification purposes.

· Suggested – Pre-addressed stamped envelope.

OFFEROR SHOULD PLACE THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE In accordance with SECTION 002116 – PROPOSAL EVALUATIONS AND BASIS FOR AWARD, completed questionnaires should be returned to the Offeror and included with the proposal.

SAMPLE TRANSMITTAL LETTER AND PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Your Company Letterhead

Date:

To:

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm will be submitting a proposal under a project advertised by the USPFO _________. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process. We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Only one response from each office is required.

Please return your completed questionnaire to my attention at the following address:

[Contractor to enter his/her address for receipt of documents and incorporation into the proposal package]

This documentation must arrive NOT LATER THAN [Contractor to enter date] , so that it can be incorporated into our proposal.

If you have questions regarding the attached questionnaire, or require assistance, please contact the USPFO Contracting Officer at ______________ via email (preferred) at: or alternatively by telephone at XXX-XXX-XXXX. Thank you for your assistance.

Signature and Title

National Guard PAST PERFORMANCE QUESTIONNAIRE (Exhibit C)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

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:

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: THE NATIONAL GUARD REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS DIRECTLY BACK TO __________. THE GOVERNMENT RESERVES THE RIGHT TO VERIFY ANY AND ALL INFORMATION ON THIS FORM.

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

(U) Unsatisfactory

TO BE COMPLETED BY CLIENT

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY:

b) Ability to meet quality standards specified for technical performance

E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

3. CUSTOMER SATISFACTION:

4. MANAGEMENT/ PERSONNEL/LABOR

g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes

E VG S M U N

5. COST/FINANCIAL MANAGEMENT

b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client

E VG S M U N

c) If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns)

E VG S M U N

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

Yes No

6. SAFETY/SECURITY

a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

E VG S M U N

7. GENERAL

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

E VG S M U N

Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):