Exhibits B and C - Past Peformance Reference Questionnaire (Word Copy).docx

Solicitation W50S8J-20-R-0002

FY20 TITLE OF PROJECT: REPAIR COMMUNICATIONS AND SECURITY FORCES B26 & B27

EXHIBIT B

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 “Technical Evaluation – Subfactor 1 Worksheet”, a Past Performance Reference Questionnaire (Exhibit C). For Government contracts, send to the Contracting Officer. 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 00120 – PROPOSAL EVALUATIONS AND BASIS FOR AWARD, completed questionnaires should be sent directly to the Contracting Office (Email Preferred).

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

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 NY Air National Guard. 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 government 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. Understand that while the responses to this questionnaire may be released to the offeror, FAR 15.306(e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each firm is required.

Please return your completed questionnaire to the following address (email preferred):

109th MSG/MSC Att: SMSgt Nicholas Bastiani 1 Air National Guard Road Scotia, NY 12302 nicholas.b.bastiani.mil@mail.mil

This documentation must arrive NOT LATER THAN 1200PM EST, 04 May 2020, so that it can be evaluated with our proposal.

If you have questions regarding the attached questionnaire, or require assistance, please contact the Contracting Officer, SMSgt Nicholas Bastiani, via email (preferred) at: nicholas.b.bastiani.mil@mail.mil or alternatively by telephone at 518-344-2513. 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:

Please provide a brief description of the scope of work involved:

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 TO SMSgt Nicholas Bastiani at nicholas.b.bastiani.mil@mail.mil. 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) Adequacy of the Contractor's Quality Control

E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

3. MANAGEMENT EFFECTIVENESS:

4. COMPLIANCE WITH SAFETY STANDARDS

5. COMPLANCE WITH FEDERAL LAWS/REGULATIONS

e) Contractor was in compliance with Executive Order 16393 – Planning for Federal Sustainability in the Next Decade

Yes No N/A

6. COMPLIANCE WITH UTILIZATION OF SMALL BUSINESS REQUIREMENTS

a) Contractor was in compliance with FAR 52.219-8, Utilization of Small Business Concerns (if “No”, please explain)

Yes No N/A

7. GENERAL

a) Ability to successfully respond to emergency and/or unforeseen 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):