Exhibits_in_Word_Format.doc

Solicitation Title

NXXXXX-XX-R-XXXX

Location

Source Selection Plan

Preventative Maintenance HVAC/DDC Systems N62473-14-R-2205

MCB Camp Pendleton, CA

Source Selection Plan

EXHIBIT “A”

FACTOR 1 – RECENT, RELATIVE EXPERIENCE QUESTIONNAIRE

The purpose of this form is to provide supporting project information for Factor 1, Recent, Relevant Experience of the Offeror and Offeror’s Team. This form is to be completed by the Offeror. Only projects that fit within the parameters of this factor will be evaluated. All other projects will be removed and discarded prior to evaluation.

1. Project No. (check one): - 5 - 4 - 3 - 2 - 1

2. Contract Number, Delivery/Task Order Number, Project Number, Title, and Location:

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

100% Completion Date (mm/dd/yy):

If not completed, 80% Completion Date:

4. Estimated Contract Cost:

5. Type of Work (check all that apply):

DDC PM Boiler System PM Chiller System PM HVAC PM

6. Type of Contract (check one):

Other (explain): Service Contract

7. Name Firm Who Performed the Service Work:

In what capacity did the firm perform the service work on this project (check one):

1. Prime Contractor

2. Joint Venture

2. Subcontractor

If the firm was the Subcontractor on this project, identify the name of the firm:

If the firm who performed this service contract differs from the firm proposing on this contract, identify relationship to the firm:

Subcontractor Joint Venture Predecessor Company Subsidiary Other:___________

8. Customer/Owner Information:

Customer Name:

Organization:

Address:

Point of Contact:

Phone Number:

E-mail address:

9. Identify proposed Offeror’s Team Participants (Prime, Joint Venture, Subcontracting Firm(s), Subsidiaries) who performed service work on this project.

10. Provide a detailed description (6-8 sentences) of the contract and specifically delineate the service work performed by each of the Offeror’s Team’s participants.

11. If experience submitted is for a joint venture or subcontractor, provide a description (6-8 sentences) of the service work that the firm will be performing for the solicited contract.

12. If a predecessor company or subcontractor will be performing on this contract the Offeror must explain ((no more than six sentences) how the predecessor company or subcontractor will participate on the solicited contract:

EXHIBIT “B”

FACTOR 2- PAST PERFORMANCE ON RECENT, RELEVANT PROJECTS

1. The NAVFAC Form PPQ shall be utilized for all evaluations that require a Past Performance Questionnaire (PPQ).

2. Solicitation Submittal Requirements: IF A COMPLETED CPARS EVALUATION IS AVAILABLE, IT SHALL BE SUBMITTED WITH THE PROPOSAL. IF THERE IS NOT A COMPLETED CPARS EVALUATION, the Past Performance Questionnaire (PPQ) included in the solicitation is provided for the offeror or its team members to submit to the client for each project the offeror includes in its proposal for Factor (insert applicable factor number, usually Factor 1, and insert factor title, usually Corporate Experience). AN OFFEROR SHALL NOT SUBMIT A PPQ WHEN A COMPLETED CPARS IS AVAILABLE.

IF A CPARS EVALUATION IS NOT AVAILABLE, ensure correct phone numbers and email addresses are provided for the client point of contact. Completed PPQs should be submitted with your proposal. If the offeror is unable to obtain a completed PPQ from a client for a project(s) before proposal closing date, the offeror should complete and submit with the proposal the first page of the PPQ (Exhibit B), which will provide contract and client information for the respective project(s). Offerors should follow-up with clients/references to ensure timely submittal of questionnaires. If the client requests, questionnaires may be submitted directly to the Government's point of contact, Marlanea Kirkbride, via email at marlanea.kirkbride@navy.m.il prior to proposal closing date. Offerors shall not incorporate by reference into their proposal PPQs or CPARS previously submitted for other RFPs. However, this does not preclude the Government from utilizing previously submitted PPQ information in the past performance evaluation.”

EXHIBIT B

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: FORMCHECKBOX Prime Contractor FORMCHECKBOX Sub Contractor FORMCHECKBOX Joint Venture FORMCHECKBOX 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: FORMCHECKBOX Firm Fixed Price FORMCHECKBOX Cost Reimbursement FORMCHECKBOX 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 FORMCHECKBOX High FORMCHECKBOX Med FORMCHECKBOX 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

RATING

DEFINITION

NOTE

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:

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

3. CUSTOMER SATISFACTION:

4. MANAGEMENT/ PERSONNEL/LABOR

5. COST/FINANCIAL MANAGEMENT

Contractor Information (Firm Name): ________________________________________________

Client Information (Name): ________________________________________________________

6. SAFETY/SECURITY

7. GENERAL

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 “C”

Factor 4: Safety

2011:

If you cannot provide an EMR for 2011 indicate why.

2012:

If you cannot provide an EMR for 2012 indicate why.

2013:

If you cannot provide an EMR for 2013 indicate why.

2011:

If you cannot provide an EMR for 2011 indicate why.

2012:

If you cannot provide an EMR for 2012 indicate why.

2013:

If you cannot provide an EMR for 2013 indicate why.

EXHIBIT D - FINANCIAL QUESTIONNAIRE

Solicitation N62473-14-R-2205 (To be submitted by Offeror)

MCIWEST, ROICC Camp Pendleton, CA is currently requesting proposals for a Navy contract for HVAC/BOILER and DDC PREVENTATIVE MAINTENANCE SERVICES CONTRACT. As part of the proposal submission requirements, the Navy requests the financial information listed below with regard to our firm. In order to be responsive to the Navy’s needs, it is requested that you complete this financial questionnaire with regard to our 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 Prospective Contractor shown below. The requested information must be received by the contractor no later than __________________________ (Prospective Contractor is responsible to fill in date by which your response is needed) in order to meet the proposal submission deadline.

Prospective Contractor for which information is being requested:

Name:

Address:

City/State/Zip:

Phone Number:

Point of Contact:

Signature of Prospective Contractor or Contractor Representative Requesting Financial Information:

Name of Financial Institution: ______________________________________________________

Address: __________________________________________________________________________

Phone Number: _________________________________________________________

a. Account(s):

Checking: Date Opened:_______________ *Average Balance :___________________________

Savings: Date Opened: _______________ *Average Balance: ___________________________

*Please note that the account balances may be provided by indicating a range, or only the number of figures, e.g., low five figures, high four figures, etc.

Loan(s): Date Opened: _______________ Original Amount:____________________________

Current Balance:____________________

b. Does the Contractor have a line of credit? No Yes

Customer’s Line of Credit: ___________________________ Expiration Date:______________________

Unused Balance: _________________

c. Would you be willing to grant this customer a Line of Credit Increase, or loan, if required?

No Yes

What is the Contractor's relationship with the bank:

Other (explain): ________________________________________________ Satisfactory Outstanding How long has the Contractor been a client? ___________________________________________________________

Name of Person providing the above information

Signature and Title of Person providing the above information

Phone Number of Person providing the above information

Revised April 2012

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY

PAGE

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY