Attch_4_-_Portable_Toilets_Experience_Questionnaire.doc

FOR OFFICIAL USE ONLY (WHEN COMPLETED)

Attachment 4

Portable Toilets

EXPERIENCE QUESTIONNAIRE

GENERAL CONTRACT INFORMATION:

Contractor performing service: ______________________________________ Cage Code: __________________ Is/was this contractor the _____ Prime or ______Sub?

If sub, name of prime:_____________________________________ Contractor Address: ___________________________________________________________________________

Contractor Phone #: _____________________

Contract type (check all that apply)

[ ] Firm-Fixed Price [ ] Cost Reimbursement [ ] Cost Plus Incentive Fee [ ] Requirements

[ ] Indefinite Delivery / Indefinite Quantity [ ] Time & Materials [ ] Award Fee

[ ] Other ____________________________

Contract number: _____________________ Awarded By (agency, company, etc.)_______________________ Description of service (i.e. type of portable toilets provided, quantities provided, services provided, time period over which services were performed, place of performance, etc).: ____________________________________________

Basic period

Option Year 1

Option Year 2

Option Year 3

Option Year 4

6 Month Extension Option

Total Value

(Add additional rows or alter as needed.)

If the total value at contract at award is different from the value reported above, please provide the starting value and explain why the value has changed: ________________________________________________________________

CONTRACTOR ADMINISTRATOR / POINT OF CONTACT (POC) INFORMATION

Name & title of POC:_________________________________________________________________________ POC’s company / agency / office symbol _________________________________________________________ Phone & fax (Commercial and/or DSN): ___________________________________________________________ E-mail address: _____________________________________________________________________________ Dates of involvement in program/contract:_________________________________________________________ Date questionnaire completed: __________________________________________________________________

1. Ability to meet unit ordering and scheduling timelines. The VAFB PWS, paragraph 1(a)(2) requires the contractor to respond to fax or email notifications within 30 minutes and paragraph 4(e) requires the contractor to respond to after-hours calls within 1 hour. Describe your ability to respond to customer inquires/orders within the stated timelines. If the referenced contract has similar requirements describe required response times in the referenced contract and your success rate in meeting the timelines.

2. Ability to meet schedule for unit delivery and placement. The VAFB Performance Work Statement (PWS), paragraph 1(a)(3), requires the contractor to deliver and place units within 3 hours for routine requests and 2 hours for emergency requests. Describe the delivery requirements for the referenced contract and your success rate in meeting the delivery times.

3. Provide location(s) of stored units available for delivery (i.e., a storage facility near VAFB which would accommodate the required timelines for unit delivery and placement).

4. Unit delivery and placement, anchoring/securing of units. VAFB consistently experiences high winds (over 35 knots/40 mph). Describe how you will anchor/secure units for the following type areas to prevent units from blowing over:

a. Soft areas (i.e. dirt/gravel/rocky/grass).

b. Asphalt.

c. Concrete.

5. Describe your ability to support the number of permanent units and fluctuating numbers of temporary units as reflected in the historical data in Appendix A of the PWS.

6. Describe resources (equipment, personnel, etc.) available to meet the requirements of the PWS.

7. Additional Information. Provide any other information pertinent to this acquisition and the PWS that would assist the Government in determining the technical capability of your company to meet the Government’s requirements.

Portable Toilets Attachment 4