ATTACHMENT_A-L_19R1215_06SEP19.pdf

AIRCRAFT PAINT COMPLEX NBC N62473-19-R-1215

NAVFAC SW

ATTACHMENT A

N62473-19-R-1215

FINANCIAL QUESTIONNAIRE

(To be submitted by Offeror)

NAVFAC Southwest, San Diego, California is currently considering award of a Navy contract to our firm. Prior to award, 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 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: _____________________________________________________________

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: _________________________________________________________

Account Number: __________________________________________

Type of Account: __________________________________________

Average Figure: ___________________________________________

Does the Contractor have a line of credit? Yes No

What is the limitation? _________________________ Unused Balance: ______________________

What is the Contractor's relationship with the bank:

Outstanding Satisfactory Other (explain): ____________________________________

How long has the Contractor been a client? _______________________________

Signature and Title of Person providing the above information

Please provide any additional comments that may help determine business and financial reputation and integrity of the prospective contractor on a separate sheet.

ATTACHMENT B

EXHIBIT “A”

OFFEROR TEAM COMPOSITION AND

MANAGEMENT

N62473-19-R-1215

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 or other partnership, list each partner as a separate team member. Modify form as necessary to include all primary construction and design team members.

Do not exceed two (2) pages.

Offeror Name: Role:

Contractual relationship to the team:

Describe team member role, responsibilities, and meaningful involvement in performance of the contract:

Team Member Name: Role:

Contractual relationship to the team:

Describe team member role, responsibilities, and meaningful involvement in performance of the contract:

Team Member Name: Role:

Contractual relationship to the team:

Describe team member role, responsibilities, and meaningful involvement in performance of the contract:

Team Member Name: Role:

Contractual relationship to the team:

Describe team member role, responsibilities, and meaningful involvement in performance of the contract:

Team Member Name: Role:

Contractual relationship to the team:

Describe team member role, responsibilities, and meaningful involvement in performance of the contract:

Team Member Name: Role:

Contractual relationship to the team:

Describe team member role, responsibilities, and meaningful involvement in performance of the contract:

Discuss the rationale for proposing this team arrangement:

ATTACHMENT C

EXHIBIT “B”

OFFEROR’S TEAM CONSENT FORM

FOR THE RELEASE OF PAST AND PRESENT PERFORMANCE INFORMATION

TO THE PRIME CONTRACTOR

N62473-19-R-1215 Past performance information concerning subcontractors and teaming partners cannot be disclosed to a private party without the subcontractor’s or teaming partner’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 major 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:

Team Member Subsidiary Subcontractor Design Subcontractor (Lead Design Firm) Parent Company 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:

ATTACHMENT D

EXHIBIT “C”

SURETY FORM

N62473-19-R-1215 (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:

ATTACHMENT E

EXHIBIT “D”

CONSTRUCTION EXPERIENCE PROJECT DATA SHEET – OFFEROR

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. Do not exceed two (2) pages per project.

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

1. Offeror Name:

Firm who performed the work:

Performed this work as: Prime Contractor Subcontractor Joint Venture Other (explain):

If subcontractor, name of prime: Phone #:

If the firm who performed this project differs from the Offeror proposing on this contract, identify the firm’s relationship to the Offeror:

Joint Venture Partner Partner Subsidiary Parent Company

Affiliate Predecessor Company Other:

Explain how this firm will have meaningful involvement in the performance of the contract:

Note: The firm who performed the work of this project must be named on Exhibit “A” and fully described as a team member who will have meaningful involvement in performance of the relevant work of this contract. If the Offeror fails to demonstrate the firm’s meaningful involvement in the performance of this contract, the project will not be considered relevant and will not be evaluated.

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 Note: If firm is indicated as a subcontractor in Block 1, provide the price of the subcontract.

4. Type of Contract: Design-Build. If D-B, design firm was:

(check one) Design-Bid-Build

Other (explain)

5. Type of Work: New Construction Renovation Repair

Alteration Other (explain):

Client/Owner Information:

6. Client Owner:

Point of Contact Name/Title:

POC Phone Number: POC Email Address:

Project Description:

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 description of the design effort:

9. Percentage of work your firm self-performed (see definition): % Provide a detailed description of the work your firm self-performed on this project. Note: do not include project administration or management functions (i.e. quality control, safety) or miscellaneous work (i.e. clean-up).

10. Describe in detail specific sustainable features incorporated in this project. Attach certifications received, if any (will not count toward page limitation).

Note: Form may be expanded to maximum of 2 pages.

ATTACHMENT F

EXHIBIT “E”

DESIGN EXPERIENCE PROJECT DATA SHEET – DESIGN FIRM

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. Do not exceed two (2) pages per project.

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, name of Lead Design Firm: Phone #:

If the firm who performed the work differs from the Design Firm named above, identify the firm’s relationship to the named Design Firm.

Joint Venture Partner Subsidiary Satellite Office Parent Company

Affiliate Predecessor Company Other:

Explain the relationship and how this firm will have meaningful involvement in the performance of the contract:

Note: The firm who performed the work of this project must be named on Exhibit “A” and fully described as a team member who will have meaningful involvement in performance of the relevant work of this contract. If the Offeror fails to demonstrate the firm’s meaningful involvement in the performance of this contract, the project will not be considered relevant and will not be evaluated.

Design Contract:

2. Contract/Project No.: Delivery/Task Order Number:

Title:

Location:

3. Award Date (mm/dd/yy): Final Actual/Estimated Construction Cost: $

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

Other

5. Type of Work: New Construction Renovation Repair

Alteration Other (explain):

Client/Owner Information:

6. Client/Owner:

Point of Contact Name/Title:

POC Phone Number: POC Email Address:

Project Description:

7. Provide a detailed description of the project and the relevancy to the project requirements of this RFP.

8. Provide a detailed description of the work your design firm self-performed on this project.

9. Describe in detail specific sustainable features incorporated in this project. Attach certifications received, if any (does not count toward page limitation).

10. Describe in detail specific Building Information Modeling (BIM) element(s) used in the design of this project to produce a complete set of construction documents.

Note: Form may be expanded to maximum of 2 pages.

ATTACHMENT G

EXHIBIT “F”

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0) CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information Firm Name: CAGE Code:

Address: Entity Identifier 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

RATING DEFINITION NOTE

(E) Exceptional Performance meets contractual requirements and exceeds many to the Government/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) Participation 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

5. COST/FINANCIAL MANAGEMENT

a) Ability to meet the terms and conditions within the contractually agreed price(s)? E VG S M U N

Contractor Information (Firm Name): ________________________________________________

Client Information (Name): ________________________________________________________

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 users 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):

ATTACHMENT H

EXHIBIT “G”

PAST PERFORMANCE – SMALL BUSINESS PARTICIPATION

N62473-19-R-1215 This form is to be completed by all Offerors (both large and small businesses) in order to provide supporting information for evaluation of Factor 3, Past Performance. Round all percentages to the nearest tenth of a percent (i.e., include only 1 number after the decimal point).

Include actual dollar values subcontracted for each of the categories listed. Include the percentage goal only if a goal was established. If established goals were not met on any submitted projects, an explanation for each unmet goal is required. If goals were not established for a project, mark N/A.

Project #1: Contract/Project Number/Task Order Number:

Project Title:

ACTUAL GOAL

(if applicable)

Total Project Dollar Value: $ Whole Dollars

Percent of line (c)

Percent of line (c) N/A Total Subcontracted Value: $

(a) Small Business Concerns (Including SB, SDB, WOSB, HUBZone SB, VOSB, SDVOSB, and HBCU/MI)

(b) Large Business Concerns $ % %

(c) Total (sum of lines a & b above) $ % %

(d) Small Disadvantaged Business Concerns $ % %

(e) Women-Owned Small Business Concerns $ % %

(f) HUBZone Small Business Concerns $ % %

(g) Veteran-Owned Small Business Concerns $ % %

(h) Service-Disabled Veteran-Owned Small Business Concerns $ % % Explanation of each unmet goal (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #2: Contract/Project Number/Task Order Number:

Project Title:

ACTUAL GOAL

(if applicable)

Total Project Dollar Value: $ Whole Dollars

Percent of line (c)

Percent of line (c) N/A Total Subcontracted Value: $

(a) Small Business Concerns (Including SB, SDB, WOSB, HUBZone SB, VOSB, SDVOSB, and HBCU/MI)

(b) Large Business Concerns $ % %

(c) Total (sum of lines a & b above) $ % %

(d) Small Disadvantaged Business Concerns $ % %

(e) Women-Owned Small Business Concerns $ % %

(f) HUBZone Small Business Concerns $ % %

(g) Veteran-Owned Small Business Concerns $ % %

(h) Service-Disabled Veteran-Owned Small Business Concerns

Explanation of each unmet goal (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #3: Contract/Project Number/Task Order Number:

Project Title:

ACTUAL GOAL

(if applicable)

Total Project Dollar Value: $ Whole Dollars

Percent of line (c)

Percent of line (c) N/A Total Subcontracted Value: $

(a) Small Business Concerns (Including SB, SDB, WOSB, HUBZone SB, VOSB, SDVOSB, and HBCU/MI)

(b) Large Business Concerns $ % %

(c) Total (sum of lines a & b above) $ % %

(d) Small Disadvantaged Business Concerns $ % %

(e) Women-Owned Small Business Concerns $ % %

(f) HUBZone Small Business Concerns $ % %

(g) Veteran-Owned Small Business Concerns $ % %

(h) Service-Disabled Veteran-Owned Small Business Concerns $ % % Explanation of each unmet goal (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #4: Contract/Project Number/Task Order Number:

Project Title:

ACTUAL GOAL

(if applicable)

Total Project Dollar Value: $ Whole Dollars

Percent of line (c)

Percent of line (c) N/A Total Subcontracted Value: $

(a) Small Business Concerns (Including SB, SDB, WOSB, HUBZone SB, VOSB, SDVOSB, and HBCU/MI)

(b) Large Business Concerns $ % %

(c) Total (sum of lines a & b above) $ % %

(d) Small Disadvantaged Business Concerns $ % %

(e) Women-Owned Small Business Concerns $ % %

(f) HUBZone Small Business Concerns $ % %

(g) Veteran-Owned Small Business Concerns $ % %

(h) Service-Disabled Veteran-Owned Small Business Concerns $ % % Explanation of each unmet goal (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Project #5: Contract/Project Number/Task Order Number:

Project Title:

ACTUAL GOAL

(if applicable)

Total Project Dollar Value: $ Whole Dollars

Percent of line (c)

Percent of line (c) N/A Total Subcontracted Value: $

(a) Small Business Concerns (Including SB, SDB, WOSB, HUBZone SB, VOSB, SDVOSB, and HBCU/MI)

(b) Large Business Concerns $ % %

(c) Total (sum of lines a & b above) $ % %

(d) Small Disadvantaged Business Concerns $ % %

(e) Women-Owned Small Business Concerns $ % %

(f) HUBZone Small Business Concerns $ % %

(g) Veteran-Owned Small Business Concerns $ % %

(h) Service-Disabled Veteran-Owned Small Business Concerns $ % % Explanation of each unmet goal (if applicable):

Name of customer reference for this project:

Phone Number:

Email address:

Note: Form may be expanded.

ATTACHMENT I

EXHIBIT “H”

SAFETY DATA SHEET

N62473-19-R-1215 This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor. EMR, DART, and TRC rates shall not be submitted for subcontractors.

Joint Venture (JV) or Partnership: Complete Blocks 1 through 6 for each contractor who is part of the JV or partnership. Only one safety narrative (Block 9) 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): 2017 2018 2019

3a. For EMRs greater than 1.0, explain any extenuating circumstances and corrective actions taken:

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

2017 2018 2019

Instructions for calculating the DART rate can be found at http://www.bls.gov/iif/osheval.htm.

6a. For DART Rates of 3.0 or greater, explain any extenuating circumstances and corrective actions taken:

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:

Note: Form may be expanded.

http://www.bls.gov/iif/osheval.htm

EXHIBIT “H” (continuation)

SAFETY NARRATIVE

N62473-19-R-1215

7. U.S. Dept. of Labor, OSHA Total Recordable Case (TRC)

Rate 2014 2015 2016

Instructions for calculating the TRC rate can be found at http://www.bls.gov/iif/osheval.htm.

8a. For TRC Rates of 4.5 or greater, explain any extenuating circumstances and corrective actions taken:

8b. Explain any upward or downward TRC Rate trends:

8c. If you do not have a TRC Rate for a given year, state so here and explain why:

9. Technical Approach for Safety: Provide the Safety Narrative using this form. Do not exceed page limitation specified in the RFP. 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 the safety management system that the Offeror will use to oversee the safety compliance and performance of self-performed and subcontractor performed work:

http://www.bls.gov/iif/osheval.htm

EXHIBIT “H” (continuation)

SAFETY NARRATIVE

N62473-19-R-1215

9. Technical Approach for Safety (continuation): Provide the Safety Narrative using this form. Do not exceed page limitation specified in the RFP. Any additional pages will not be considered.

Describe any innovative methods that the Offeror will employ to ensure and monitor safe work practices at self-performed and all subcontractor levels:

Describe the methodology that the Offeror will use in order to execute an effective program that facilitates sound mishap prevention techniques and processes, employee reporting of unsafe conditions, unsafe activities, and near-miss mishaps:

Describe the Offeror’s Good Catch Program and safety deficiency correction procedure(s):

ATTACHMENT J

EXHIBIT “I”

SMALL BUSINESS PARTICIPATION PLAN

N62473-19-R-1215 This form is to be completed by all Offerors (both large and small businesses) in order to provide supporting information for evaluation of Factor 6, Small Business Participation. Round all percentages to the nearest tenth of a percent (i.e., include only 1 number after the decimal point).

1. Offeror Info:

Offeror Name:

Applicable size category for the Offeror under the NAICS Code identified on the SF 1442 for this solicitation (check one):

Large Business (LB) Small Business (SB)

If the Offeror is a Small Business, check all socioeconomic categories that apply to the Offeror. If none of the socioeconomic categories apply to the Offeror, check NONE:

Historically Underutilized Business Zone Small Business (HUBZone SB) Woman-Owned Small Business (WOSB) Small Disadvantaged Business (SDB) Veteran-Owned Small Business (VOSB) Service-Disabled Veteran-Owned Small Business (SDVOSB)

NONE

2. Subcontracting Breakdown:

a. Total contract value (sum of b + c): $ 100%

b. Estimated value of all planned subcontracting

(inclusive of all planned subcontracting to all businesses, regardless of size):

$ % of 2.a

c. Estimated value of all work to be self-performed by Offeror’s workforce: $ % of 2.a

3. Subcontracts for products and services to be awarded under this contract:

a. Large Business:

Name of Subcontractor Type of Product/Service

Type of Commitment to Subcontractor:

Estimated Subcontract Value

Teaming Agreement Letter of Commitment Other:

Other:

This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are Large Business concerns. $

b. Small Business:

Name of Subcontractor Type of Product/Service

Type of Commitment to Subcontractor:

1. This number represents total planned subcontracting dollars under this contract that will go to subcontractors who are Small Business concerns (includes all SB, HUBZone SB, WOSB, SDB, VOSB, and SDVOSB concerns); Historically Black Colleges, Universities, and Minority Institutions (HBCU/MI); AbilityOne participating non-profit agencies for the blind or severely disabled; and Alaskan Native Corporations (ANCs) and Indian Tribes as prescribed in FAR 19.703(c) & FAR 52.219-9.

2. If the Offeror is a Small Business concern, enter the dollar amount that the Offeror will self-perform (line 2.c). $

Total planned dollars under this contract that will go to SB concerns (sum of 3.b.1 + 3.b.2): $

Total proposed small business participation rate (in terms of percentage of total contract value): % of 2.a All Offerors who are not able to meet the minimum total small business participation rate (20% of the total contract value) shall provide a detailed explanation why the minimum total small business participation rate cannot be achieved:

c. HUBZone SB:

Name of Subcontractor Type of Product/Service

Type of Commitment to Subcontractor:

go to subcontractors who are qualified HUBZone SB concerns certified by the Small Business Administration (SBA).

2. If the Offeror is a HUBZone SB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). $

Total planned dollars under this contract that will go to HUBZone SB concerns (sum of 3.c.1 + 3.c.2): $

d. WOSB:

Name of Subcontractor Type of Product/Service

Type of Commitment to Subcontractor:

go to subcontractors who are small business concerns 51% owned and controlled by one or more women.

2. If the Offeror is a WOSB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). $

Total planned dollars under this contract that will go to WOSB concerns (sum of 3.d.1 + 3.d.2): $

e. SDB:

Name of Subcontractor Type of Product/Service

Type of Commitment to Subcontractor:

go to subcontractors who are small business concerns owned and controlled by one or more socially and economically disadvantaged individuals (include in this category the planned subcontracting dollars to HBCU/MIs, and the planned subcontracting dollars to ANCs and Indian Tribes).

2. If the Offeror is a SDB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). $

Total planned dollars under this contract that will go to SDB concerns (sum of 3.e.1 + 3.e.2): $

f. VOSB:

Name of Subcontractor Type of Product/Service

Type of Commitment to Subcontractor:

one or more qualifying veterans (include in this category the planned subcontracting dollars to SDVOSB concerns shown in 3.g below).

2. If the Offeror is a VOSB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). $

Total planned dollars under this contract that will go to VOSB concerns (sum of 3.f.1 + 3.f.2): $

g. SDVOSB:

Name of Subcontractor Type of Product/Service

Type of Commitment to Subcontractor:

one or more qualifying service-disabled veterans.

2. If the Offeror is a SDVOSB concern, enter the dollar amount that the Offeror will self-perform (line 2.c). $

Total planned dollars under this contract that will go to SDVOSB concerns (sum of 3.g.1 + 3.g.2): $

4. If the Offeror does not intend to subcontract, provide a detailed explanation why subcontracting would not result in efficient contract performance.

Notes:

(1) Lines 2.b + 2.c = 100% of Line 2.a

(2) Lines 3.a + 3.b.1 = 100% of Line 2.b

(3) Subcontracts to companies that qualify in multiple categories of SB must be reported under each category. For example:

if you are planning to subcontract $100,000 to company ABC, a woman-owned, small disadvantaged business that is also a certified HUBZone SB, you will report $100,000 in block 3.b (SB), 3.c (HUBZone SB), 3.d (WOSB) and 3.e (SDB).

(4) The sum of 3.c.1 through 3.g.1 does not automatically equate to the value of line 3.b.1.

(5) Designated HUBZone SB concerns must be certified by SBA.

(6) Large business Offerors selected for award shall be required to submit an acceptable Small Business Subcontracting Plan incorporating the proposed subcontract values and any specifically identified small business concerns. The Small Business Subcontracting Plan shall also include small business subcontracting goals that meet or exceed the minimum small business subcontracting targets stated in the solicitation. If the Offeror fails to negotiate an acceptable subcontracting plan, the Offeror will be ineligible for award.

(7) This form may be expanded as needed.

ATTACHMENT K

EXHIBIT “J”

INDIVIDUAL SMALL BUSINESS SUBCONTRACTING PLAN

This template is designed to be consistent with FAR 19.704, Subcontracting Plan Requirements and FAR clause 52.219-9, Small Business Subcontracting Plan (“subcontracting plan”). Other formats may be acceptable, including commercial or master subcontracting plans; however, failure to include the essential information exemplified in this individual plan template may be cause for delay in acceptance or rejection of a bid/offer.

(TO BE SUBMITTED BY OTHER THAN SMALL BUSINESSES ONLY)

(Also referred to as large businesses)

(CONTRACTOR’S NAME)

(ADDRESS)

(CONTRACTOR’S CORPORATE HEADQUARTERS ADDRESS)

[If same as above, so indicate].

(Solicitation or Contract Number)

(Title of the Project and Location)

(Date Prepared)

PLAN SUBMITTED BY:

Signature: __________________________________ Date: ____________________

Printed Name: ___________________________________________________________

Title: __________________________________________________________________

REVIEWED:

Small Business Professional Date

REVIEWED:

Small Business Administration Date Procurement Center Representative

ACCEPTED:

Procuring Contracting Officer Date

ATTACHMENT K- CONTINUATION

SUBCONTRACTING PLAN

This document, together with any attachments, is submitted as a subcontracting plan to satisfy the requirements of Federal Acquisition Regulations (FAR) 19.704. The following goals are established for the contract (including base period and all option items/periods (if applicable)). Attachment 1 provides breakdowns for the base year.

Percentages may be rounded to nearest tenth of a percent. INCLUDE SUPPORTING RATIONALE FOR ALL

PROPOSED GOALS AND ENSURE THIS PLAN IS CONSISTENT WITH ANY SMALL BUSINESS

PARTCIPATION AND COMMITMENT STRATEGY ASSOCIATED WITH THIS ACQUISITION.

1. a. Total Contract Value $_______________ (including options)

b. Total Subcontracted $_______________ _______% of 1.a (inclusive of all planned subcontracting to all businesses, regardless of size)

c. Total Prime-performed $_______________ _______% of 1.a

2. The following dollars and percentage goals are applicable to the contract cited above. (See FAR 19.704(a)(1) and (2))

a. Large Business $_______________ _______% of 1.b

This number represents total planned subcontract dollars that will be awarded to other than small business concerns (including subcontracts awarded to Historically Black Colleges, Universities and Minority Institutions (HBCU/MIs).

b. Small Business (SB) $_______________ _______% of 1.b

This number represents total planned subcontract dollars that will be awarded to small business concerns** as well as subcontracts awarded under the AbilityOne Program to SourceAmerica (formerly NISH) and National Industries for the Blind (NIB) organizations and subcontracts awarded to Alaskan Native Corporations (ANCs) and Indian Tribes as prescribed in FAR 19.703(c) & FAR 52.219-9.

(** Small business concerns include SBs, Small Disadvantaged Businesses (SDB), Women-Owned Small Businesses (WOSB), Historically Underutilized Business Zone (HUBZone) small businesses, Veteran-Owned Small Businesses (VOSB) and Service-Disabled Veteran-Owned Small Businesses (SDVOSB))

(Include 2.c, 2.d, 2.e, 2.f, 2.g, 2.h, and 2.i, below).

Notes:

(1) Lines 1.b + 1.c=100% of Line 1.a

(2) Lines 2.a + 2.b = 100% of Line 1.b

(3) Lines 2.c, 2.d, 2.e, 2.f, 2.g, 2.h, and 2.i are calculated against Line 1.b, the total value of overall subcontract dollars.

(4) Subcontracts to companies that qualify in multiple categories of SB must be reported under each category. For example: if you are planning to subcontract $100,000 to company ABC, a woman-owned SDB that is also a certified HUBZone SB, you will report $100,000 on line 2.b (SB), 2.c (HUBZone), 2.d (WOSB) and 2.e (SDB). Accordingly, the sum of 2.c through 2.i will not necessarily equate to the value of 2.b.

(5) Designated HUBZone SBs must be certified by the Small Business Administration (SBA).

c. HUBZone SB $______________ ________% of 1.b

This number represents total planned subcontract dollars that will be awarded to qualified HUBZone small business concerns certified by SBA. (Included in total for 2.b, above)

d. WOSB $_______________ ________% of 1.b

This number represents total planned subcontract dollars under that will be awarded to WOSBs. (Included in total for 2.b, above)

e. SDB $______________ ________% of 1.b

This number represents total planned subcontracting dollars that will be awarded to small business concerns owned and controlled by socially and economically disadvantaged individuals (include in this category the planned subcontracting dollars to ANCs and Indian Tribes shown in total for 2.i below). (Included in total for 2.b, above)

f. VOSB $_______________ ________% of 1.b

This number represents total planned subcontract dollars that will be awarded to small business concerns owned and controlled by veterans (include in this category the planned subcontracting dollars for SDVOSBs shown in 2.g below). (Included in total for 2.b, above)

g. SDVOSB $_______________ ________% of 1.b

This number represents total planned subcontract dollars under this contract that will be awarded to subcontractors who are small business concerns owned and controlled by service-disabled veterans. (Included in totals for 2.b and 2.f, above)

h. AbilityOne $_______________ ________% of l.b.

This number represents total planned subcontract dollars that will be awarded to AbilityOne associated nonprofit agencies through SourceAmerica and NIB. Per DFARS 219.703, subcontracts awarded to qualified non-profit agencies for the blind or severely disabled may be counted toward the small business subcontracting goal.

(Included in total for 2.b, above)

i. Alaskan Native Corporations & Indian Tribes $_______________ ________% of l.b.

This number represents total planned subcontract dollars that will be awarded to ANCs and Indian Tribes and for which the prime contractor has been designated to receive SDB credit. (See FAR 19.703 & FAR 52.219-9) (Included in totals for 2.b and 2.e, above)

3. The following principal products and/or services will be subcontracted under this contract. (See FAR 19.704(a)(3)

a. Products/services planned to be subcontracted to LB concerns (including HBCU/MIs):

Firm subcontract commitments :

Name of Company/DUNS Products or Services

b. Products/services planned to be subcontracted to SB concerns:

Firm subcontract commitments:

Name of Company/DUNS Products or Services

c. Products/services planned to be subcontracted to certified HUBZone concerns:

Firm subcontract commitments:

Name of Company/DUNS Products or Services

d. Products/services planned to be subcontracted to WOSB concerns:

Firm subcontract commitments:

Name of Company/DUNS Products or Services

e. Products/services planned to be subcontracted to SDB concerns:

Firm subcontract commitments:

Name of Company/DUNS Products or Services

f. Products/services planned to be subcontracted to VOSB concerns:

Firm subcontract commitments:

Name of Company/DUNS Products or Services

g. Products/services planned to be subcontracted to SDVOSB concerns:

Firm subcontract commitments:

Name of Company/DUNS Products or Services

h. Products/services planned to be subcontracted to AbilityOne organizations:

Firm subcontract commitments:

Name of Organization/DUNS Products or Services

i. Planned products/services to be subcontracted to ANCs and Indian Tribe businesses (See 2.i above for explanation):

Firm subcontract commitments:

Name of Company/DUNS Products or Services

4. The following methods were used to develop the above subcontracting goals. Include a statement explaining how the products and services to be subcontracted were established, how the products and services to be subcontracted to SB, SDB, WOSB, HUBZone, VOSB, SDVOSB concerns, AbilityOne program participants, ANCs and Indian Tribes were determined, and how their capabilities were assessed. (See FAR 19.704(a)(4))

5. The following methods were/will be used to identify potential sources for solicitation purposes: (See FAR

19.704(a)(5)) The offeror may rely on the information contained in SAM as an accurate representation of a concern’s size and ownership characteristics for the purposes of maintaining a SB, VOSB, SDVOSB, HUBZone, SDB, and WOSB source list. Use of SAM as a source list does not relieve the offeror of its responsibilities (e.g., outreach, assistance, counseling, or publicizing subcontracting opportuniuties.

6. Indirect and overhead costs have have not been included in the goals specified in 1. and 2. above. If "have" is checked, explain the method used in determining the proportionate share of indirect costs to be incurred with SBs (including all subcategories delineated above). (See FAR 19.704(a)(6))

7. The following employee will administer the subcontracting program: (See FAR 19.704(a)(7))

NAME: ________________________________________________________________

ADDRESS: ________________________________________________________________

TELEPHONE NO.:_____________________ FAX NO.: ___________________________

EMAIL: ____________________________________________________________________

TITLE: _____________________________________________________________________

This individual has general overall responsibility for the company's small business program. This person should have knowledge of the federal small business programs and be knowledgeable about federal procurement practices. If the prime decides to change the person in this position, they must notify the Contracting Officer and the Deputy for Small Business. The administrator is responsible for the development, preparation and execution of this subcontracting plan, and for monitoring performance relative to contractual subcontracting requirements contained in this plan, including:

a. Developing and maintaining bidders lists of SB, SDB, WOSB, HUBZone SB, VOSB, SDVOSB concerns, AbilityOne program participants, HBCU/MIs, ANCs, and Indian Tribes (hereafter referred to as the small business community) from all possible sources.

b. Counsel and discuss subcontracting opportunities with representatives of the small business community.

c. Ensuring that procurement packages are structured to permit the small business community to participate to the maximum extent possible.

d. Assuring inclusion of the small business community in all solicitations for products or services, which they are capable of providing.

e. Reviewing solicitations to remove statements, clauses, etc., which may tend to restrict or prohibit the small business community participation.

f. Assign each subcontract the NAICS code and corresponding size standard that best describes the principal purpose of the subcontract.

g. Confirm that a subcontractor representing itself as a HUBZone small business concern is certified by SBA as a HUBZone small business concern by SBA in accordance with 52.219-8(d)(2)

h. Provide notice to subcontractors concerning penalties and remedies for misrepresentations of business status as small, veteran-owned small business, HUBZone small, small disadvantaged, or women-owned small business for the purpose of obtaining a subcontract that is to be included as part or all of a goal contained in the subcontracting plan.

i. Ensuring periodic rotation of potential subcontractors on bidders lists.

j. Ensuring that the bid proposal review board documents its reasons for not selecting low bids submitted by the small business community.

k. Ensuring the establishment and maintenance of records of solicitations and subcontract award activity.

l. Attending or arranging for attendance of company counselors at Business Opportunity Workshops, Minority

Business Enterprise Seminars, Trade Fairs, etc.

m. Conducting or arranging for the motivational training for purchasing personnel pursuant to the intent of P.L.

95-507.

n. Monitoring attainment of proposed goals.

o. Preparing and submitting required periodic subcontracting reports.

p. Coordinating contractor's activities during the conducting of compliance reviews by Federal agencies.

q. Coordinating the conduct of contractor's activities involving its small business subcontracting program.

r. Additional duties.

8. The following efforts will be taken to ensure that the small business community will have an equitable opportunity to compete for subcontracts. (See FAR 19.704(a)(8))

a. Outreach efforts will be made by identifying:

- Contacts with minority and small business trade associations.

- Contacts with business development organizations.

- Attendance at small and minority business procurement conference and trade fairs.

b. Sources will be requested from the System for Award Management (SAM) website available at https://www.sam.gov/ on the Internet.

Automated data base sources to be used, other than SAM, will be as follows.

c. The following internal efforts will be made to guide and encourage buyers:

(i) Workshops, seminars and training programs will be conducted.

(ii) Activities will be monitored to evaluate compliance with this subcontracting plan.

(iii) Arrange interviews with the small business community.

https://www.sam.gov/

d. Describe how your small business database, source lists, guides, and other data will be maintained and utilized by buyers in soliciting subcontracts; e.g., rotation of firms in the data base, keeping data base current and useful.

9. Provide assurances the offeror agrees that the FAR clause 52.219-8 entitled "Participation of Small Business

Concerns " will be included in all subcontracts which offer further subcontracting opportunities, and all subcontractors, except SB concerns, that receive subcontracts in excess of $700,000 ($1,500,000 for construction) will be required to adopt plans that comply with the requirements of the clause at 52.219-9, Small Business Subcontracting Plan. Such plans will be reviewed by comparing them with the provisions of P.L. 95-507 and assuring that all minimum requirements of an acceptable subcontracting plan have been satisfied. The acceptability of percentage goals shall be determined on a case-by-case basis depending on the supplies/services involved, the availability of potential small and small disadvantaged subcontractors, and prior experience. Once approved and implemented, plans will be monitored through the submission of periodic reports, and/or, as time and availability of funds permit, periodic visits to review subcontracting program progress. (See FAR 19.704(a)(9))

10. Provide assurances the offeror will submit such periodic reports and cooperate in any studies or surveys as may be required by the contracting agency or the Small Business Administration in order to determine the…