N6247314R0001_Exhibits_Forms.docx
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- N6247314R0001
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Exhibits to use for Proposal
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N62473-14-R-0001 - EXHIBITS AND FORMS
All the forms are editable and are to be used when preparing the proposal.
Page 2.
EXHIBIT “A”- OFFEROR TEAM COMPOSITION AND MANAGEMENT (Factor 1)
Page 3.
EXHIBIT “B”- CONSTRUCTION EXPERIENCE PROJECT DATA SHEET – OFFEROR (Factor 2) Page 5.
EXHIBIT “B”- DESIGN EXPERIENCE PROJECT DATA SHEET – DESIGN FIRM (Factor 2)
Page 7.
EXHIBIT “C”- NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0) (Factor 3)
Page 11.
EXHIBIT “D”- SAFETY DATA SHEET/ SAFETY NARRATIVE (Factor 4)
After Proposal Cover Letter – before Tab 1:
Page 13. FINANCIAL QUESTIONNAIRE
Page 14. SURETY FORM
Page 15. OFFEROR’S TEAM CONSENT FORM
Use this form or an email with the same information as the RFI form when submitting questions:
Page 16. REQUEST FOR INFORMATION (RFI)
EXHIBIT “A”
OFFEROR TEAM COMPOSITION AND MANAGEMENT
N62473-14-R-0001
Use this form to provide information regarding the primary members, composition, and management of the proposed design-build team for Factor 1, Technical Approach. If Offeror is a Joint Venture, Mentor-Protégé or other legal partnership, list each partner as a separate team member. Modify form as necessary to include all primary construction and design team members.
| Offeror |
| Name: |
Role:
Contractual relationship to the team:
Team member role and responsibilities in performance of the contract:
| Team Member |
| Name: |
Role:
Contractual relationship to the team:
Team member role and responsibilities in performance of the contract:
| Team Member |
| Name: |
Role:
Contractual relationship to the team:
Team member role and responsibilities in performance of the contract:
| Team Member |
| Name: |
Role:
Contractual relationship to the team:
Team member role and responsibilities in performance of the contract:
| Team Member |
| Name: |
Role:
Contractual relationship to the team:
Team member role and responsibilities in performance of the contract:
| Team Member |
| Name: |
Role:
Contractual relationship to the team:
Team member role and responsibilities in performance of the contract:
Discuss the rationale for proposing this team arrangement:
Note: Form may be expanded.
Exhibit “A” – Offeror Team Composition and Management, Page 1 of 16
(Rev 8/13)
EXHIBIT “B”
CONSTRUCTION EXPERIENCE PROJECT DATA SHEET – OFFEROR
N62473-14-R-0001
This form is to be completed by the Offeror. Submit (one per project) in order to provide supporting project information for Factor 2, Experience. Only projects that are within the project description parameters of the solicitation will be considered relevant. Submit up to 5 projects. All other projects will not be considered.
Project No. (check one): |_| - 1 |_| - 2 |_| - 3 |_| - 4 |_| - 5
Contractor:
| 1. |
| Offeror Name: |
| Firm who performed the work: |
| Offeror Performed this work as: | ||
| |_| Prime Contractor | |_| Subcontractor | |_| Joint Venture Member |
| |_| Other (explain): |
If Offeror performed as:
(1) subcontractor for this project provide name of prime, or
(2) member of a joint venture provide name of other JV member:
| POC Name: |
Phone #:
| If the firm who performed the work for this project differs from the Offeror proposing on this contract, identify the firm’s relationship to the Offeror: |
| |_| Joint Venture Member|_| Legal Partner |
|_| Mentor Protégé |_| Parent Company |_| Subsidiary |_| Satellite Office |_| Predecessor Company |_| Other:
Note: For evaluation purposes the address provided in Block 14 of the SF 1442 must match the address included on the Cover Sheet and/or PPQ/CCASS evaluation for this project. If it is a different address a complete explanation must be provided below.
Explain how this firm will have meaningful involvement in the performance of the contract:
Construction Contract:
| 2. |
| Contract/Project No.: |
| Delivery/Task Order Number: |
| Title: |
| Location: |
| 3. |
| Award Date (mm/dd/yy): |
| Award Amount: $ |
| Completion Date (mm/dd/yy): |
| Final Price: $ |
This is the: |_| total project |_| subcontract price
| 4. |
| Type of Contract: |
| |_| Design-Build. If D-B, design firm was: |
| (check one) |
| |_| Design-Bid-Build (bid from fully designed plans and specifications) |
Customer:
| 5. |
| Name: |
| Point of Contact Name/Title: |
| POC Phone Number: |
| POC Email Address: |
Project Description:
6. Type of Work (check all that apply): |_| New Construction |_| Renovation |_| Repair
7. Provide a detailed description of the project and the relevancy to the project requirements of this RFP:
8. If project is design-build, provide a detailed description of the design effort:
9. Percentage of work your firm self-performed (see definition): % Provide a detailed description of what work your firm self-performed on this project.
10. Describe in detail specific sustainable features of this project.
Exhibit “B” – Project Experience - Offeror, Page 3 of 16
(Rev 8/13)
EXHIBIT “B”
DESIGN EXPERIENCE PROJECT DATA SHEET – DESIGN FIRM
N62473-14-R-0001
This form is to be completed by the Design Firm. Submit (one per project) in order to provide supporting project information for Factor 2, Experience. Only projects that are within the project description parameters of the solicitation will be considered relevant. Submit up to 5 projects. All other projects will not be considered.
Project No. (check one): |_| - 1 |_| - 2 |_| - 3 |_| - 4 |_| - 5
Design Firm:
| 1. |
| Design Firm Name: |
| Design Firm Address: |
| Firm who performed the work: |
| Performed this work as: | |
| |_| Lead Design Firm | |_| Consultant |
| |_| Other (explain): |
| If Consultant, provide name of Lead Design Firm: |
| Phone #: |
| Identify the design firm’s relationship to the Offeror: |
| |_| Joint Venture Member |
|_| Legal Partner |_| Subcontractor |_| Parent Company |_| Subsidiary |_| Satellite Office |_| Predecessor Company |_| Other:
Note: For evaluation purposes the address provided above must match the address included on the proposal Cover Letter and/or PPQ/ACASS evaluation for this project. If the address is different a complete explanation must be provided below.
Explain how this firm will have meaningful involvement in the performance of the contract:
Design Contract:
| 2. |
| Contract/Project No.: |
| Delivery/Task Order Number: |
| Title: |
| Location: |
| 3. |
| Award Date (mm/dd/yy): |
| Final Estimated Construction Cost (ECC): $ |
| Design Completion Date (mm/dd/yy): |
(excluding any construction phase support services such as PCAS)
| 4. |
| Type of Contract: |
| |_| Design-Build. If D-B, Construction Contractor was: |
| (check one) |
| |_| Design-Bid-Build (bid from fully designed plans and specifications) |
Customer:
| 5. |
| Name: |
| Point of Contact Name/Title: |
| POC Phone Number: |
| POC Email Address: |
Project Description:
6. Type of Work (check all that apply): |_| New Construction |_| Renovation |_| Repair
7. Provide a detailed description of the project and the relevancy to the project requirements of this RFP:
8. Provide a detailed description of what work your design firm self-performed on this project.
9. Describe in detail specific sustainable features of this project.
Exhibit “B” – Project Experience – Design Firm, Page 5 of 16
(Rev 8/13)
EXHIBIT “C”
NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)
CONTRACT INFORMATION (Contractor to complete Blocks 1-4)
| 1. Contractor Information | |
| Firm Name: | CAGE Code: |
| Address: | DUNs Number: |
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:
4. Project Description:
Complexity of Work |_| High |_| Med |_| Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)
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: NAVFAC REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS DIRECTLY BACK TO THE OFFEROR. THE OFFEROR WILL SUBMIT THE COMPLETED QUESTIONNAIRE TO NAVFAC WITH THEIR PROPOSAL, AND MAY DUPLICATE THIS QUESTIONNAIRE FOR FUTURE SUBMISSION ON NAVFAC SOLICITATIONS. CLIENTS ARE HIGHLY ENCOURAGED TO SUBMIT QUESTIONNAIRES DIRECTLY TO THE OFFEROR. HOWEVER, QUESTIONNAIRES MAY BE SUBMITTED DIRECTLY TO NAVFAC. PLEASE CONTACT THE OFFEROR FOR NAVFAC POC INFORMATION. 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
Revised April 2011
Exhibit “C” – PPQ, Page 7 of 16 (Rev 12/11)
RATING DEFINITION NOTE
| (E) Exceptional |
| Performance meets contractual requirements and exceeds many to the Government’s/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective. |
| An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified. |
| (VG) Very Good |
| Performance meets contractual requirements and exceeds some to the Government’s/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective. |
| A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner. There should have been NO significant weaknesses identified. |
| (S) Satisfactory |
| Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory. |
| A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract. |
| (M) Marginal |
| Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented. |
| A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government/Owner. |
| (U) Unsatisfactory |
| Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor's corrective actions appear or were ineffective. |
| An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating. |
| (N) Not Applicable |
| No information or did not apply to your contract |
| Rating will be neither positive nor negative. |
Contractor Information (Firm Name): ________________________________________________ Client Information (Name): ________________________________________________________
TO BE COMPLETED BY CLIENT
PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS
YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.
1. QUALITY
| a) Quality of technical data/report preparation efforts |
| E VG S M U N |
| b) Ability to meet quality standards specified for technical performance |
| E VG S M U N |
| c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance |
| E VG S M U N |
| d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance) |
| E VG S M U N |
2. SCHEDULE/TIMELINESS OF PERFORMANCE
| a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below) |
| E VG S M U N |
| b) Rate the contractor’s use of available resources to accomplish tasks identified in the contract |
| E VG S M U N |
3. CUSTOMER SATISFACTION
| a) To what extent were the end users satisfied with the project? |
| E VG S M U N |
| b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports, businesslike and communication) |
| E VG S M U N |
| c) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer? |
| E VG S M U N |
| d) Overall customer satisfaction |
| E VG S M U N |
4. MANAGEMENT/PERSONNEL/LABOR
| a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force |
| E VG S M U N |
| b) Ability to hire, apply, and retain a qualified workforce to this effort |
| E VG S M U N |
| c) Government Property Control |
| E VG S M U N |
| d) Knowledge/expertise demonstrated by contractor personnel |
| E VG S M U N |
| e) Utilization of Small Business concerns |
| E VG S M U N |
| f) Ability to simultaneously manage multiple projects with multiple disciplines |
| E VG S M U N |
| g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes |
| E VG S M U N |
| h) Effectiveness of overall management (including ability to effectively lead, manage and control the program) |
| E VG S M U N |
Contractor Information (Firm Name): ________________________________________________ Client Information (Name): ________________________________________________________
5. COST/FINANCIAL MANAGEMENT
| a) Ability to meet the terms and conditions within the contractually agreed price(s) |
| E VG S M U N |
| b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client. |
| E VG S M U N |
| c) If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns). |
| E VG S M U N |
| d) Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section. |
| Yes No |
| e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below. |
| Yes No |
| f) Have there been any indications that the contractor has had any financial problems? If yes, please explain below. |
| Yes No |
6. SAFETY/SECURITY
| a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the user’s rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.) |
| E VG S M U N |
| b) Contractor complied with all security requirements for the project and personnel security requirements. |
| E VG S M U N |
7. GENERAL
| a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues). |
| E VG S M U N |
| b) Compliance with contractual terms/provisions (explain if specific issues) |
| E VG S M U N |
| c) Would you hire or work with this firm again? (If no, please explain below) |
| Yes No |
| d) In summary, provide an overall rating for the work performed by this contractor. |
| 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):
EXHIBIT “D”
SAFETY DATA SHEET
N62473-14-R-0001
This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor. EMR and DART rates shall not be submitted for subcontractors.
Joint Venture (JV): Provide a Safety Data Sheet for each contractor who is part of the JV or legal partnership; however, only one safety narrative is required.
1. Offeror Name:
Name of JV partner providing the information below (if applicable):
Offeror’s Three Previous Complete Calendar Years of Reported Safety Data:
Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers.
| 2. Experience Modification Rate (EMR): |
| 2010 |
| 2011 |
| 2012 |
3a. Explain any extenuating circumstances resulting in any EMRs greater than 1.0:
3b. Explain any upward or downward EMR trends:
3c. If you do not have an EMR for a given year, state so here and explain why:
4. Insurance Carrier Information:
Insurance Carrier Name:
| Agent’s name: |
| Phone No.: |
| Email: |
| 5. U.S. Dept. of Labor, OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate* |
| 2010 |
| 2011 |
| 2012 |
6a. Explain any extenuating circumstances resulting in any DART Rates of 3.0 or greater:
6b. Explain any upward or downward DART Rate trends:
6c. If you do not have a DART Rate for a given year, state so here and explain why:
EXHIBIT “D” (continuation)
SAFETY NARRATIVE
N62473-14-R-0001
7. Technical Approach for Safety: Provide the Safety Narrative using this form. Do not exceed 2 pages. Any additional pages will not be considered.
Describe the plan that the Offeror will implement to evaluate safety performance of potential subcontractors, as a part of the selection process for all levels of subcontractors:
Describe any innovative methods that the Offeror will employ to ensure and monitor safe work practices at all subcontractor levels:
Exhibit “D” – Safety Data Sheet/Safety Narrative, Page 11 of 16
(Rev 8/12)
FINANCIAL QUESTIONNAIRE
N62473-14-R-0001
(To be completed by Financial Institution and submitted by Offeror)
NAVFAC Southwest, San Diego, California is currently considering award of a Navy contract to this firm. Prior to award, the Navy requests the financial information listed below with regard to this firm. In order to be responsive to the Navy’s needs, it is requested that you complete this financial questionnaire with regard to this firm. Upon completion of the questionnaire it is requested that you place the completed questionnaire in a sealed envelope showing the return address of the financial institution and forward it to the Offeror shown below. The requested information must be received by the contractor no later than _______________________
Prospective Contractor for which information is being requested:
| Name: |
| Address: |
| Phone Number: |
| Point of Contact:: |
Signature of Prospective Contractor or Contractor Representative Requesting Financial Information
| Name of Financial Institution: |
| Address: |
| Phone Number: |
| Account Number: |
| Type of Account: |
| Average Balance Figure : |
Does the Contractor have a line of credit? |_| Yes |_| No
| What is the limitation? |
| Remaining Balance: |
What is the Contractor’s relationship with the bank?
| |_| Outstanding |_| Satisfactory |_| Other (explain): |
| How long has the Contractor been a client? |
| Name and Title of person providing the above information: |
Signature of person providing the above information
Please provide any additional comments that may help determine the business and financial reputation and integrity of the prospective contractor on a separate sheet.
Financial Questionnaire, Page 13 of 16
(Rev 12/12)
SURETY FORM
N62473-14-R-4001
(Bonding Capacity) (To be completed by Surety and submitted by Offeror)
| Surety Name: |
| Agent’s Name: |
| Address: |
| Phone Number: |
| Contractor (Offeror) Name: |
| Address: |
| Phone Number: |
| How long have you provided bonding for the above Contractor? |
How would you rate your relationship with this contractor?
| |_| Excellent |_| Satisfactory |_| Unsatisfactory |_| Other: |
If Unsatisfactory please explain:
| Bonding limit for a single project? $ |
| Aggregate bonding amount? $ |
| Current available bonding? $ |
Have you ever had to complete a project for the Contractor? |_| YES |_| NO
| If yes, explain: |
Have there been complaints of non-payment by subcontractors/suppliers? |_| YES |_| NO
| If yes, explain: |
Has the surety had to pay subcontractors/suppliers? |_| YES |_| NO
| If yes, explain: |
Surety Form, Page 14 of 16
(Rev 12/12)
OFFEROR’S TEAM CONSENT FORM
FOR THE RELEASE OF PAST AND PRESENT PERFORMANCE INFORMATION
TO THE PRIME CONTRACTOR
N62473-14-R-0001
Past performance information concerning subcontractors/teaming members cannot be disclosed to a private party without the subcontractor’s/teaming member’s consent. Because a prime contractor is considered a private party, the Government requires the consent of the subcontractor/teaming partner before disclosing past and present performance information to the prime contractor during exchanges. In an effort to assist the Government in evaluating past performance relevancy and confidence, we request that a consent form be completed by the subcontractors/teaming partners identified in the Offeror’s proposal.
THIS FORM IS TO BE COMPLETED BY THE ENTITY THAT IS PROVIDING CONSENT TO THE PRIME CONTRACTOR. USE THIS FORM (ONE PER ENTITY) TO PROVIDE CONSENT TO ALLOW THE GOVERNMENT TO DISCUSS YOUR PAST AND PRESENT PERFORMANCE INFORMATION WITH THE PRIME CONTRACTOR DURING THE SOURCE SELECTION PROCESS.
In responding to the solicitation number identified above, we are participating as a:
| |_| Legal Partnership | |_| Subsidiary |
| |_| Parent Company | |_| Lead Design Firm (Design Subcontractor) |
|_| Other Affiliate:
| with: | |
| Offeror Name (prime contractor or name of entity providing proposal) |
We understand that the Government will be evaluating our past performance as part of the source selection evaluation for the solicitation number identified above. In order to facilitate the performance confidence assessment process, we are signing this consent form to allow you to discuss our past and present performance information with the prime contractor during the source selection process.
| Name of Entity Providing Consent: |
| Address: |
| Phone Number: |
| Email Address: |
| DUNS Number: |
| CAGE Code: |
| Name of Individual with Authority to Sign for and Legally Bind the Company: |
| Title: |
| Signature: |
| Date: |
Offeror’s Team Consent Form, Page 15 of 16
(Rev 8/13)
REQUEST FOR INFORMATION (RFI)
N62473-14-R-4001
The Government does not intend to respond to inquiries submitted less than 10 days before the proposal receipt date shown in the solicitation. Please submit questions using this form or include the same information in an email to Nancy LeSage at nancy.lesage@navy.mil.
| Firm Name: |
| POC: |
| Address: |
| Phone Number: |
| Email Address: |
QUESTION IS REGARDING:
| Section of the RFP:: |
| Paragraph:: |
| Page Number:: |
QUESTION:
RFI Form, Page 16 of 16
(Rev 12/12)
File details come from the government source that posted it. Updated .