L-03 Offeror Response Template_v2.pdf

MDA Solicitation

HQ05925RE001

Attachment L-04

Offerer Response Template

Name of Offeror Submitting a Proposal: _______ _

CAGE Code of Offeror Submitting a Proposal: _______ _

This template shall not be altered beyond completing the fillable fields. No other document will be accepted by the

Government for the review of Factor I as provided in sections L-3.0 and M-3.0 of the solicitation.

Instructions: Offerors must provide a minimum of two but no more than three experiences related to the scope area provided in Section C paragraph 2 of the solicitation. The experience provided must be from a missile defense or similarly related application. All fields must be filled in and shall not be cross referenced to a different portion of the proposal. This template must be signed in the applicable fields by the cognizant contracting officer or private sector equivalent such as a company official who is authorized to contractually bind their organization. In lieu of a signature, the offeror may choose to provide a Federal Procurement Data System (FPDS) record of the contract action via the FPDS eZ search (https://www.fpds.gov/fpdsng_cms/index.php/en/). If an FPDS record is provided for the corporate experience, a signature is not required. If the appropriate fields are not signed or an FPDS print-out is not provided, then the corporate experience shall not be considered acceptable.

€ORPOBATE EXPERIENCE NUMBER A

List the scope area(s) from paragraph 2 of Section C of the solicitation:

1. Experience for: D Offeror for this Solicitation D Other {Identify below, e.g.: Joint Venture

Member, Corporate affiliate, Subcontractor, etc.)

Name of entity that performed services for this Project:

Fill in the fields below as applicable.

Entity CAGE: Entity UEI: Entity EIN:

2. Entity role in project: D Prime Contractor D Joint Venture Member

D Other (Identify):

Percent of project work performed by entity listed in Box 1:

Percent of project work subcontracted:

3. Contract Number:

Deliveryffask Order Number (if applicable):

Title: Location:

Client Point of Contact: Client Phone Number:

Attachment L-04

Offeror Response Template

Client Email Address:

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

5. Type of Contract: (Check ALL that apply)

0 Firm-Fixed Price O Cost/Time and Material

0 Other (explain): ________ _

6. Provide a detailed description of the experience and the relevancy to the requirements of this solicitation.

This field will be character limited to approximately 600 characters. This is approximately 8 lines of text at

Times New Roman, 11-point font.

Choose One: FPDS-NG record (attached) 0 Signature below by reference identified in Block 3 0

The signature below by a Contracting Officer, Contracting Officer's Representative, or Corporate Official for the ordering activity constitutes acceptance of the above project information to be accurate as ordered and received by the listed entity.

Signature Block will be added below:

Attachment L-04

Offeror Response Template

List the scope area(s) from paragraph 2 of Section C of the solicitation:

1. Experience for: D Offeror for this Solicitation D Other (Identify below, e.g.: Joint Venture Member, Corporate affiliate, Subcontractor, etc.)

Name of entity that performed services for this Project:

Fill in the fields below as applicable.

Entity CAGE: _____ Entity UEI: ______ Entity EIN:

2. Entity role in project: D Prime Contractor D Joint Venture Member

D Other (Identify): ________________ _

Percent of project work performed by entity listed in Box 1: _______ _

Percent of project work subcontracted: _______ _

3. Contract Number: _________________ _ Deliveryffask Order Number (if applicable): __________ _

Title: --------------- Location: ____________ _

Client Point of Contact: Client Phone Number:

Client Email Address: ---------

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

5. Type of Contract: (Check ALL that apply)

D Firm-Fixed Price D Costffime and Material

D Other (explain): ________ _

Attachment L-04

Offeror Response Template

6. Provide a detailed description of the experience and the relevancy to the requirements of this solicitation.

This field will be character limited to approximately 600 characters. This is approximately 8 lines of text at

Times New Roman, 11-point font.

Choose One: FPDS-NG record (attached) D Signature below by reference identified in Block 3 D

The signature below by a Contracting Officer, Contracting Officer's Representative, or Corporate Official for the ordering activity constitutes acceptance of the above project information to be accurate as ordered and received by the listed entity.

Signature Block will be added below:

CORPORATE EXPERIENCE NUMBER C

List the scope area(s) from paragraph 2 of Section C of the solicitation:

1. Experience for: D Offeror for this Solicitation D Other (Identify below, e.g.: Joint Venture

Member, Corporate affiliate, Subcontractor, etc.)

Name of entity that performed services for this Project:

Fill in the fields below as applicable.

Entity CAGE: Entity UEI: Entity EIN:

2. Entity role in project: D Prime Contractor D Joint Venture Member

D Other (Identify):

Percent of project work performed by entity listed in Box 1:

Percent of project work subcontracted:

Attachment L-04

3. Contract Number:

Offeror Response Template

De Ii very ff ask Order Number (if applicable):

Title: Location:

Client Point of Contact:

Client Email Address:

4. Award Date (mm/dd/yy):

Completion Date (mm/dd/yy):

5. Type of Contract: (Check ALL that apply)

0 Firm-Fixed Price O Costffime and Material

0 Other (explain):

C Ii en t Phone Number:

6. Provide a detailed description of the experience and the relevancy to the requirements of this solicitation.

This field will be character limited to approximately 600 characters. This is approximately 8 lines of text at

Times New Roman, 11-point font.

Choose One: FPDS-NG record (attached) 0 Signature below by reference identified in Block 3 0

The signature below by a Contracting Officer, Contracting Officer's Representative, or Corporate Official for the ordering activity constitutes acceptance of the above project information to be accurate as ordered and received by the listed entity.

Signature Block will be added below:

Attachment L-04

Offeror Response Template

This section is for Government use only.

Name of Offeror Submitting a Proposal: _______ _

CAGE Code of Offeror Submitting a Proposal: _______ _

Rating Assigned

D Acceptable D Unacceptable

Comments

Evaluator Signature:

Validation of Experience

D Yes D No

Comments

Verifier Signature: