Exhibits A-G.pdf

Exhibit A

BASE PERIOD AND OPTION YEAR SUBCONTRACTING GOALS

(SOLICITATION N62473-20-R-0075)

Base Period Option Period 1 Option Period 2 Option Period 3 Option Period 4 Total Periods

1.a Total Contract $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

1.b Total Subcontracted $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.a) % __________ % __________ % __________ % __________ % __________ % __________

1.c Total Prime $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.a) % __________ % __________ % __________ % __________ % __________ % __________

2.a To LB $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.b) % __________ % __________ % __________ % __________ % __________ % __________

2.b To SB $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.b) % __________ % __________ % __________ % __________ % __________ % __________

2.c To HUBZone SB $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.b) % __________ % __________ % __________ % __________ % __________ % __________

2.d To WOSB $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.b) % __________ % __________ % __________ % __________ % __________ % __________

2.e To SDB $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.b) % __________ % __________ % __________ % __________ % __________ % __________

2.f To VOSB $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.b) % __________ % __________ % __________ % __________ % __________ % __________

2.g To SDVOSB $ ___________ $ ___________ $ ___________ $ ___________ $ ___________ $ ___________

(% of Line 1.b) % __________ % __________ % __________ % __________ % __________ % __________

2.h To AbilityOne $___________ $___________ $___________ $___________ $___________ $___________

(% of Line 1.b) %___________ %___________ %___________ %___________ %___________ $___________

2.i To ANCs/Indian Tribes

(% of Line 1.b) %___________ %___________ %___________ %___________ %___________ %___________

EXHIBIT B

FINANCIAL QUESTIONNAIRE

SOLICITATION NO: N62473-20-R-0075

(To be completed and submitted via secure email by the Financial Institution ) NAVFAC Southwest 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 submit the completed questionnaire via email to samantha.m.king@navy.mil and terry.a.hardin@navy.mil. 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 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? _______________________________

Signature of person providing the above information

Print Name and Title of person providing the above information mailto:samantha.m.king@navy.mil mailto:terry.a.hardin@navy.mil mailto:terry.a.hardin@navy.mil

EXHIBIT C

FACTOR 1 - RECENT, RELEVANT EXPERIENCE OF FIRM PROJECT DATA SHEET

This form is to be completed by the offeror. Use this form (one per project) to provide supporting project information for Factor 1, Recent, Relevant Experience of Firm. Offeror may submit a minimum of 2 and a maximum of 4 projects. Total page limit for each project shall NOT exceed 3 single pages. For multiple award and indefinite delivery/indefinite quantity (IDIQ) type contracts, the contract as a whole shall NOT be submitted as a project;

rather offeror’s shall submit the work performed under a task order as a project. See Factor 1 for proposal submission requirements and basis of evaluation.

1. Offeror Name: __________________ JV Partner Name: __________________ (if applicable)

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

3. Award Date (mm/dd/yy): __________________ Completion Date (mm/dd/yy): __________________ Project is _______% complete

4. Award Amount (including all options) :

Total Annual Award Value $ _____________ Amount billed/invoiced: $ _____________ Final Contract Price (including all options):

If the Final contract price above is: subcontract price Provide total project price: $ _______________

5. Type of Contract (check one): FFP MASC IDIQ BOSC OTHER

6. This project was Performance Based YES NO

7.Customer/Owner Name:

Point of Contact Name/Title: (person with project knowledge) POC Phone Number: POC Email Address: __________________

8. Name of Firm that Performed the Work:

This firm performed the work as (check one): Prime Contractor Subcontractor*

*provide the name of the prime contractor:

If the firm who performed this project differs from the offeror submitting a proposal under this solicitation, identify the relationship to the offeror below:

Key Personnel** Subsidiary Satellite Office Parent Company Predecessor Company

**If this project was performed by offeror key personnel, identify the name of the individual, name of firm they worked for, and describe their involvement on this project:

9. If this project was performed by offeror key personnel, a subsidiary, satellite office, parent company, predecessor company, provide a detailed explanation how this office/person will participate in this contract.

10. Percentage of work firm self-performed (see “self-perform” definition) on this project: _______% Provide detailed description of what work your firm self-performed on this project. If performed as subcontractor, provide a detailed description of what work your firm self-performed as a subcontractor on this project.

11. Identify annexes below that are relevant to this project (include dollar amount and % of work your firm self-performed).

Relevancy of this project to RFP Annex

Annex Number / Name

Contract Price

Percentage of work your Firm self-performed

Yes - or - No

1503030 ISWM $ %

ALL OTHER WORK $ %

TOTAL (Should equal block 4, Final Contract Price) - $ 100 %

EXHIBIT E

FACTOR 2 - TECHNICAL APPROACH

Submit Exhibit E (TECHNICAL APPROACH) in accordance with solicitation submittal requirements.

EXHIBIT E IS MANDATORY. Individual blocks on this form may be expanded; however, total page limit shall not exceed fifteen (15) single-sided 8.5” x 11” pages using not smaller than 10-point Times New Roman font. An Offeror may utilize different font types and sizes for the organizational chart and other charts and graphs as long as the information contained in those charts and graphs are legible. See Factor 2 for proposal submission requirements and basis of evaluation.

1. Work to be Performed by Offeror under the Basic Contract:

2. Staffing Plan:

3. Technical Performance Plan:

EXHIBIT D

FACTOR 3 - MANAGEMENT APPROACH

Submit Exhibit D (MANAGEMENT APPROACH) in accordance with solicitation submittal requirements.

EXHIBIT D IS MANDATORY. Individual blocks on this form may be expanded; however, total page limit shall not exceed twenty (20) single-sided 8.5” x 11” pages using not smaller than 10-point Times New Roman font. An Offeror may utilize different font types and sizes for the organizational chart and other charts and graphs as long as the information contained in those charts and graphs are legible. See Factor 3 for proposal submission requirements and basis of evaluation.

1. Operations and Management Plan:

2. Management Methodology:

3. Organization Chart:

4. Work Reception Plan:

5. Capacity Response:

6. Recruitment:

7. Contractor Furnished Property:

8. Phase-In Plan:

EXHIBIT F

SAFETY DATA & NARRATIVE

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; however, only one safety narrative is required. See Factor 4 for proposal submission requirements and basis of evaluation.

1. Offeror Name:

Name of Joint Venture partner providing the information below (if applicable):

Offeror’s Three Previous (complete) Years of Reported Safety Data:

Only complete year safety data will be considered. Indicate data rates as decimal figures, not whole numbers. NOTE: Blank entries will be considered non-responsive. If you have no established rates, annotate block with “see narrative below.”

2. Experience Modification Rate (EMR) 2017 2018 2019

3a. Explain any extenuating circumstances resulting in any EMRs greater than 1.0, and address any corrective action(s) taken:

3b. Explain any upward 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 Number:

5. U.S. Dept. of Labor, OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate*

2017 2018 2019

*For each year, submit a completed copy of U.S. Dept. of Labor, OSHA Form 300A (Summary of Work- Related Injuries and Illnesses), latest version. This information is required regardless of number of employees in the company.

6a. Explain any extenuating circumstances resulting in any DART rates 3.0 or greater, and address any corrective action(s) taken:

6b. Explain any upward DART rate trends:

6c. If you do not have a DART rate for a given year, state so here and explain why:

http://www.bls.gov/respondents/iif/forms/oshaforms.pdf

EXHIBIT F

SAFETY DATA & NARRATIVE

7. Provide the Technical Approach for Safety using this form. The Technical Approach for Safety Narrative shall not exceed two (2) single pages. Any additional pages will not be considered.

Technical Approach for Safety:

7a. Describe the plan the offeror will implement to evaluate the safety program and performance of potential subcontractors:

7b. Describe the plan to monitor subcontractor worksite safety:

7c. Describe any innovative methods the offeror will employ that may enhance worksite safety for this procurement:

7d. Describe their methodology to execute an effective program that facilitates sound mishap prevention techniques and processes, employee reporting of unsafe conditions, unsafe activities, and near-miss mishaps:

Note: Form may be expanded.

EXHIBIT G

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 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: