RE RFP Appendices B-F.docx

APPENDICES

SMITHSONIAN-WIDE REAL ESTATE SERVICE PROVIDER RFP

SMITHSONIAN SOLICITATION NUMBER F09SOL00066

APPENDIX B

OFFEROR’S INTERIM FINANCIAL DATA FORM

Interim Financial Data For the ________ month period ending ___________, _____

CASH

ACCOUNTS RECEIVABLE

CONTRACTS (COMPLETED)

CONTRACTS (IN PROGRESS)

OTHER RECEIVABLES

LESS: RESERVE FOR UNCOL.

NOTES RECEIVABLE

COSTS IN EXCESS OF BILLING

INVENTORIES

MARKETABLE SECURITIES

PREPAID EXPENSES

OTHER CURRENT ASSETS

TOTAL CURRENT ASSETS

NOTES PAYABLE

ACCOUNTS PAYABLE

ACCRUED EXPENSES

BILLINGS IN EXCESS OF COST

DEFERRED TAXES

OTHER CURRENT LIABILITIES

TOTAL CURRENT LIABILITIES

Long Term Liabilities

NOTES PAYABLE

DEFERRED TAXES

OTHER L/T LIABILITIES

TOTAL L/T LIABILITIES

Fixed Assets

Net Worth

LAND

BUILDINGS

EQUIPMENT

FURNITURE & FIXTURES

LESS: ACCUM. DEPREC.

OTHER FIXED ASSETS

TOTAL FIXED ASSETS

CAPITAL STOCK

ADDITIONAL PAID-IN

RETAINED EARNINGS

TREASURY STOCK

OTHER ADJUSTMENTS

TOTAL NET WORTH

TOTAL LIAB+ NET WORTH

EARNED REVENUES+INCOME

COST OF REVENUES EARNED

GROSS INCOME

GENERAL & ADMIN, EXPENSE

NET INCOME

Other Assets

LIFE INSURANCE (CASH VALUE)

LONG TERM INVESTMENTS

OTHER ASSETS

TOTAL FIXED ASSETS

TOTAL ASSETS

APPENDIX C

CONTRACTOR’S BACKGROUND FORM

(submit under Tab 1(d))

A. Entity Name: _____________________________________________________________

Street Address: ____________________________________________________________

City/State/Zip: _____________________________________________________________

Main telephone # _____ - ______ - ___________, Fax # _____ - ______ - ___________

B. Identification of two (2) contact people within the entity:

Name Title Phone Number Email Address

C. Entity making this submittal:

Parent Company _______ Subsidiary _______ Division ________ Branch Office ________

Other :________________________________________________________________________

D. Type of Entity:

Corporation _____ Partnership _____ Sole Proprietorship _____ Joint Venture ______

Other ________________________________________________________________________

E. Year Entity was established: _____________

F. Name, address, and telephone number of parent company (enter N/A if not applicable).

G. All former company names (enter N/A if not applicable). ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

H. Is your Entity recognized as a Minority Business Enterprise (MBE), Women Owned Business (WBE), or Small Business Enterprise (SBE)?

SBE: no ___, yes ___; MBE: no ___, yes ___; WBE: no ___, yes ___

I. Joint Venture: If this Qualification Statement is being presented by a Joint Venture, please indicate the participation of each Joint Venture. If not a Joint Venture, indicate Not Applicable (N/A).

PARTICIPATION

PERCENTAGE OF

FINANCIAL PARTICIPATION

PERCENTAGE

OPERATIONAL

PARTICIPATION

J. Judgments, Claims, and Lawsuits

Are there any judgments, claims, and/or lawsuits pending or outstanding against or involving your entity or partners comprising your entity? No ___, Yes ___. If “Yes,” submit details of all judgments or claims against either parent office or division/branch that will be responsible for the accomplishment of this project on a separate sheet under Tab 2.

K. Key Personnel: List officers, Partners and/or Owners

IN THE FIRM

NUMBER OF YEARS

WITH THE FIRM

YEARS OF

EXPERIENCE

L. Is your entity or partners comprising your entity under suspension or debarment by any Federal, state or local agency or been terminated on any past projects (Postal or others)?

No ___, Yes ___. If “Yes,” submit details on a separate sheet attached hereto.

N. Affirmation: I _______________________________, hereby certify that I am the authorized representative of the entity submitting this Qualification Statement, and that the following statements are true to the best of my knowledge, information, and belief:

I affirm that neither the entity, nor any officer, controlling shareholder, partner, or principal, nor any other person substantially involved in the contracting activities of the entity has in the past five (5) years:

(1) Been convicted under state or Federal statutes of a criminal offense incident to obtaining or attempting to obtain or performing a public or private contract.

(2) Been convicted under state of Federal statutes or fraud, embezzlement, theft, forgery, falsification or destruction of records, or receiving stolen property.

(3) Been found civil liable under state or Federal antitrust or other statutes for acts or omissions in connection with submission of bids or proposals for or performance of a public or private contract.

(4) Been criminally convicted of any violation of a state or Federal antitrust statute.

(5) Been convicted under the provisions of Title 18 of the United States Code for violation of the Racketeer Influence and Corrupt Organization Act, 18 USC, Section 1961 et seq. or the Mail Fraud Act, 18 USC, Section 1341 et seq., for acts arising out of the submission of Bids or Proposals for a public or private contract.

(6) Been criminally convicted of conspiracy to commit any act or omission that would constitute grounds for conviction or liability under any statute described in paragraphs (10), (2), (4), or (5) above; or

(7) Admitted in writing or under oath, during the course of an official investigation, or other proceeding, acts or omissions that would constitute grounds for conviction of liability under any statute described above.

(8) I certify that I have read and understand the instructions for completing the Qualification Statement and if I am unable to make the above Affirmation, I will provide an explanation as to why not on a separate sheet and submit under Tab 4.

Signature

Title

Entity Name

APPENDIX D

COMPARABLE EXPERIENCE FORM

(submit under Tab 2)

As required in Part I, Section F.4.1(b)hereto, list comparable experience completed or in progress during the past five (5) years. Attach more sheets as needed, using this format. Do not include more than ten (10) projects collectively for Appendices C & D.

Client Name and Location: ______________________________________________________________________________

Street/PO Box ____________________City _________________ State _____ Zip ___________

Type of Services provided___________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Contract Type: Indefinite Quantity ___, Fixed Price ____, Other ____

Contract Duration/Period of Performance ______/______/_____ - ______/_______/______

Orig. Contract Amount: $___________ Final Contract Amount: $________ % Change: ____

Orig. Contract Duration ____________ Actual Contract Duration ________ % Change: ____

Client Reference for Services:

Key Contact: ___________________________

Address: ______________________________________________________________________________

Telephone: _______________________ Email Address: _______________________________

Description of Services Provided: ____________________________________________________________________________________________________________________________________________________________

APPENDIX E

NON-COMPARABLE EXPERIENCE FORM

(submit under Tab 2)

As required in Part I, Section F.4.1(b) hereto, list non-comparable experience completed or in progress during the past five (5) years. Attach more sheets as needed, using this format. Do not include more than ten (10) projects collectively for Appendices C & D.

Client Name and Location: ______________________________________________________________________________

Street/PO Box ____________________City _________________ State _____ Zip ___________

Type of Services provided___________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Contract Type: Indefinite Quantity ___, Fixed Price ____, Other ____

Contract Duration/Period of Performance ______/______/_____ - ______/_______/______

Orig. Contract Amount: $___________ Final Contract Amount: $________ % Change: ____

Orig. Contract Duration ____________ Actual Contract Duration ________ % Change: ____

Client Reference for Services:

Key Contact: ___________________________

Address: ______________________________________________________________________________

Telephone: _______________________ Email Address: _______________________________

Description of Services Provided: ____________________________________________________________________________________________________________________________________________________________

APPENDIX F:

SCHEDULE OF FEES

The fully burdened labor rates set forth below shall apply to all individual Task Order contracts issued hereunder. In negotiating a Task Order, the Smithsonian will pay the actual rate for the individual proposed for the task by the Contractor provided said rate falls within the high and low fully burdened rates set forth below.

Fully Burdened Hourly Labor Rates

Category High Low Average Senior Executive Project Executive Program Manager Project Manager Sr*.

Project Manager Technical Specialist Sr.* Technical Specialist Financial Specialist Sr* Financial Specialist IT Specialist Sr* IT Specialist Accountant / Auditor Sr*.

Accountant / Auditor Real Property Appraiser Sr*.

Real Property Appraiser Legal Counsel Paralegal Technical Writer Sr*.

Technical Writer Researcher Sr*.

Researcher Space Planner Sr* Space Planner Contract Specialist Sr.* Contract Specialist Auditor Sr* Auditor Intern Clerical Reproduction Specialist Presentation Specialist Others (as appropriate)

*To be designated at senior rate, an individual must have a minimum of fifteen years of experience in their given field and have obtained the corresponding professional license or designation for their discipline. (CPA, MAI, etc.)

SCHEDULE OF FEES

PERCENTAGE BASED FEES

61 Months and up (% of total base rental to be paid for such months) ____

(% of total base rental to be paid for such months)

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