Attachment1FACTSSheet_revised.pdf

SOURCE SELECTION INFORMATION

SEE FAR 2.101 AND 3.104

RFP FA8533-13-R-30278

ATTACHMENT 1

SOURCE SELECTION INFORMATION - See FAR 2.101 and 3.104

FOR OFFICIAL USE ONLY

Present/Past Performance “FACTS Sheet”

(TO BE COMPLETED BY OFFEROR, JOINT

VENTURE PARTNER,)

(To Be Completed by Offeror/Joint Venture Partner)

Request the offeror complete a separate FACTS Sheet for each relevant contract. See the provision titled, “Proposal Requirements” of this RFP for detailed instructions and limits on number and recency of contracts. Offeror is requested to provide frank, concise comments regarding present/past performance on the program identified in B. below.

A. OFFEROR:

(1) Name (Company/Division):

(2) Address

(3) CAGE Code:

B. Contract Number or Project Title:

C. Role of Offeror in Effort: __________ Prime Contractor __________ Subcontractor

Note that the information provided in this FACTS Sheet shall reflect the role that the offeror performed in the effort, i.e. an offeror who performed as a subcontractor shall identify the contract type, dollar value, description, etc. of its subcontract with the prime contractor.

D. Name of Customer:

E. Contract Type(s): Check All That Apply

a. Firm Fixed Price _____

b. Time and Materials _____

c. Cost _____

d. Other (Explain)

F. Contract Dollar Value. (If you performed work as a subcontractor, identify your contract $ value and the PRIME’s contract $ value, if known. Describe any changes in dollar value that may have occurred from time of contract award to the conclusion of the effort or the present, whichever is applicable.)

1. Original Contract Dollar Value:

2. Current Dollar Value:

G. PERIOD OF PERFORMANCE: (includes start and end dates, i.e. Jan 2004 – Dec 2007)

1. Original schedule:

2. Current schedule (if changed):

3. Estimated percentage of completion:

4. How many times changed and primary causes of changes:

H. Quantities of items involved in the effort:

1. Quantities ordered

2. Quantities delivered

I. Brief Description of Effort:

1. As a part of this narrative description, highlight portions considered most relevant to the current acquisition; addressing how and to what extent the proposed effort relates to the program identified in B. above. To supplement the data provided in response to this paragraph, complete the following regarding relevancy of the effort identified in paragraph B to the proposed effort.

This is limited to three pages beyond the page limitation of the FACTS sheet information. See RFP provision, “Proposal requirements.”

2. This paragraph shall also include details to support the offeror’s record for on-time delivery, technical quality and cost control for this effort identified in paragraph B. above.

RELEVANCY TABLE

(Complete with each effort submitted for evaluation)

This table will assist the PCO in evaluating the relevancy of the proposed effort to the instant 500 Gallon Liquid Oxygen/Liquid Nitrogen Tank requirement. Offerors shall only complete column three. Offerors answers are applicable only to the effort identified in paragraph B above, not the offeror’s proposed solutions to the instant effort. If additional space is needed, please attach a separate sheet to your response (limited to three pages). Please be as specific as possible with fill-in information provided.

Category Example Fill-in for the Effort Identified in para. B above (Offeror completes)

1. Nature of Business Area(s) involved

Development, Production, Manufacturing, Testing

Circle all that apply

Design Manufacturing

2. Detailed Description of

Item

3. Mobility Trailer Mounted or Stationary Circle One

Trailer Mounted Stationary

4. Air Transportable Ability to be transported by aircraft such as the C-130, KC-10, C-17, and C-5 Aircraft

5. Self-Contained/Not Self-Contained

Circle One

Self-Contained Not Self-Contained

6. Storage of Liquid Oxygen and/or Liquid Nitrogen

Circle all that apply

Liquid Oxygen Liquid Nitrogen Other

7. Storage Capacity 100 gallon, 50 gallon, etc. List the storage capacity (gallons)

8. Inner/Outer Shell Circle Yes or No if the tank consisted of an Inner and Outer shell

Yes No

9. Quantities produced, number repaired or other quantitative data

3 or more units per month Provide quantity information

Monthly qty Yearly qty

10. Program similarity Yes or No Circle Yes or No, provide brief explanation

Yes No

11. Program Complexity Complex, Non-Complex Circle One

Complex Non-complex

12. Extent of subcontractor involvement

Prototype, production, specific assembly/role

13.

Reports/Manuals/Plans/D ata

Were Technical Reports, Safety Hazard Reports, Technical Manuals or other data required in this effort?

Describe in detail.

J. Utilization of Small Business Concerns. If you are small business, or if you are a large business and a Small Business Subcontracting Plan per FAR 52.219-9 was NOT required by this effort, indicate your compliance with FAR 52.219-8, Utilization of Small Business Concerns, by completing the following. That is, when subcontracting possibilities existed on this effort, did you award subcontracts to small business concerns, veteran-owned small business concerns, service-disabled veteran-owned small business concerns, HUBZone small business concerns, small disadvantaged business concerns, and women-owned small business concerns to the fullest extent consistent with efficient contract performance? If FAR 52.219-8 was NOT included in this effort, whenever subcontracting possibilities existed in the performance of this effort, address whether or not it was your policy to utilize small business concerns, veteran-owned small business concerns, service-disabled veteran-owned small business concerns, HUBZone small business concerns, small disadvantaged business concerns, and women-owned small business concerns to the fullest extent consistent with efficient contract performance.

Utilization of Small Business Concerns

Small Business Large Business

No subcontracting possibilities

In compliance Not in compliance (address why)

K. Key Personnel. If the offeror/joint venture partner is a newly formed entity that either has no prior contracts or does not possess relevant corporate past performance, but does have key personnel with relevant past performance while employed by another company, specify by name, such key individual(s) who will participate in the proposed effort under this acquisition who also participated in the program identified in B above, and indicate their contract role. Describe how participation of these key personnel contributed to the success of the previous effort and how this indicated probability of success on the proposed effort.

L. Discrepancies. Summarize contract issues relative to the number and severity of quality deficiencies recorded/contract discrepancy reports issued, cure notices, show cause letters, termination for default or cause, disputes, claims, latent defects; and corrective actions taken for the contract listed in paragraph B above.

Additionally, for those efforts where you are cognizant of unfavorable and/or marginal past performance ratings/reports previously assessed by customers or clients, but feel that significant progress has been made but not yet credited or formally documented, provide the program name, contract number, customer location and a narrative explaining "fixes" made to date, or any other information regarding the unfavorable/marginal assessment. It is not presumed that performance has been perfect. Rather, the proposal should contain evidence of your ability to isolate the root causes of problems and should describe programs or actions taken to resolve those causes. Demonstrated corrective actions (not just planned or promised), and the overall work record will be considered. Problems not addressed, but found by the Government during the evaluation of the information in this volume, will be assumed to still exist.

Note: In the case of Contractor Performance Assessment Report System (CPARS), if your input has already been provided and the rationale/ circumstances have not changed, DO NOT repeat them here.

M. Contract History. Was this contract effort (as identified in paragraph B. above) submitted as a past performance source of data for a previous WR-ALC procurement. Yes No . If yes, identify the buyer and/or contracting officer, their phone number and office symbol and solicitation number of the procurement for which this effort was submitted.

PLEASE NOTE: The Government is not bound by the offeror's opinion of relevancy. The Government will perform an independent assessment of relevancy of the data provided or obtained.