N6274221R0001_Attach_A_B_C.pdf

ANNOUNCMENT NO. N6274221R0001

NAVFAC 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.

ANNOUNCMENT NO. N6274221R0001

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.

Rev Oct 2016

N6274221R0001

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

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 B

SMALL BUSINESS SUBCONTRACTING RECORD

COMPANY NAME: _______________________________________

SUBCONTRACTING ACHIEVEMENTS – Include actual dollar values subcontracted for each of the categories listed. Include the percentage goal only if a goal was established. Note: Form may be expanded.

(1) Contract Number/Title:

Check One: ____ Prime Contract ____ Subcontract

Subcontracting Plan Required ____ Yes ____ No

ACTUAL

SUBCONTRACTED

SUBCONTRACT

GOAL

(if applicable)

Completion Date: Total Contract Value: $

Total Subcontracted Value: $ Whole Dollars Percent Percent

(a) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)

Small Business Concerns (Non-Federal Certifications Examples:

MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise), DVBE (Disabled Veteran Business Enterprise), SB (Small Business), WBE (Women’s Business Enterprise).

(b) Other Than Small (OTS) Business Concerns (Dollar amount and percent of line c.)

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

(d) Small Disadvantaged Business Concerns (Dollar amount and percent of line c.) Including MBE & DBE

(e) Women-Owned Small Business Concerns (Dollar amount and percent of line c.) Including WBE

(f) HUBZone Small Business Concerns (Dollar amount and percent of line c.)

(g) Veteran-Owned Small Business Concerns (Dollar amount and percent of

(h) Service Disabled Veteran-Owned Small Business Concerns (Dollar amount and percent of line c.) Including DVBE

Name of customer reference for this project: ___________________________________________

Phone Number: _______________________ FAX Number: _______________________

Email address: ________________________________________

(2) Contract Number/Title:

SUBCONTRACT

GOAL

(if applicable)

Completion Date: Contract Dollar Value: $

Total Subcontracted Value: $ Whole Dollars Percent Percent

(b) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)

Small Business Concerns (Non-Federal Certifications Examples:

MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),

(b) OTS Business Concerns (Dollar amount and percent of line c.)

(3) Contract Number/Title:

SUBCONTRACT

GOAL

(if applicable)

Completion Date: Contract Dollar Value: $

Total Subcontracted Value: $ Whole Dollars Percent Percent

(c) Small Business Concerns (Including SDB, WOSB, HUBZone, VOSB, SDVOSB and AbilityOne entities) (Dollar amount and percent of line c.)

Small Business Concerns (Non-Federal Certifications Examples:

MBE (Minority Business Enterprise), DBE (Disadvantaged Business Enterprise),

(b) OTS Business Concerns (Dollar amount and percent of line c.)

ATTACHMENT C

SMALL BUSINESS PARTICIPATION AND COMMITMENT STRATEGY

(OFFEROR’S NAME)

(ADDRESS)

Solicitation or Contract Number (Title of the Project)

(Location) (Date Prepared)

INSERT INTRODUCTION/EXECUTIVE SUMMARY (Up to 2 pages maximum)

SMALL BUSINESS PARTICIPATION AND COMMITMENT STRATEGY – (Base and Option Years)

1. Estimated value of all planned subcontracting $________________ ____% of contract

2. Estimated value of all work to be self-performed $________________ ____% of contract

3. Total value of the proposal (sum of 1. and 2. above) $________________ 100% of contract

4. Subcontracts for products and services to be awarded under this project.

a. Self-Performed Work:

TYPE OF SERVICE/PRODUCT $ VALUE OF WORK

TOTAL: $________________

PERCENTAGE OF CONTRACT VALUE (line 3) ________________%

If the offeror is a small business, the Government will add self-performed work to the appropriate category(ies) in c. (1) through c. (6) below to calculate overall small business participation rates.

b. Other Than Small (OTS) Business Subcontracts**

NAME OF COMPANY* TYPE OF SERVICE/PRODUCT $ VALUE OF SUBCONTRACT

PERCENTAGE OF CONTRACT VALUE (line 3) ________________%

c. Small Business (SB) Subcontracts

PERCENTAGE OF CONTRACT VALUE (line 3) ______________%

(1) SMALL DISADVANTAGED BUSINESSES: (SDB)

(2) WOMEN-OWNED SMALL BUSINESSES: (WOSB)

TOTAL: $_______________

(3) HISTORICALLY UNDERUTILIZED BUSINESS ZONE (HUBZone) CONCERN:

NAME OF COMPANY* TYPE OF SERVICES $ VALUE OF SUBCONTRACT

(4) VETERAN OWNED SMALL BUSINESS: (VOSB)

(5) SERVICE-DISABLED VETERAN OWNED SMALL BUSINESS: (SDVOSB)

(6) ABILITYONE PROGRAM ORGANIZATIONS

NAME OF ORG* TYPE OF SERVICES $ VALUE OF SUBCONTRACT

* For each company/organization listed, describe the nature of commitment to subcontract and whether or not it is legally binding. If unknown/to be determined, so indicate.

** Include any subcontracts to Historically Black Colleges and Universities/Minority Institutions

(HBCU/MI) in the OTS Business listing.

NOTES:

1. The dollar sum of lines 4.b and 4.c (excluding (1)-(6)) must equal line 1.

2. Lines 4.c. (1) through 4.c. (6) identify various subcategories of small businesses.

Subcontracts to companies that qualify in multiple categories must be reported under each category. For example: A $100,000 subcontract to ABC, a woman-owned, small disadvantaged business that is also a certified HUBZone concern, will be reported as $100,000 on line 4.c., SB, line 4.c. (1), SDB, line 4.c. (2), WOSB and line 4.c.(3), HUBZone concern.

3. Subcontracts to qualified nonprofit agencies participating in the AbilityOne Program are considered small business subcontracts for the purposes of this strategy and any associated small business subcontracting plan.

CONTRACT LEVEL PERFORMANCE SUMMARY

This document summarizes participation (total contract performance, including self performance and subcontracted efforts) by type of business entity in terms of both dollar value and percentage of total contract value.

Base Option 1 Option 2 TOTAL

DOLLARS

Total contract value $ $ $ $

OTS Business* $ $ $ $

SB* $ $ $ $

SDB $ $ $ $

WOSB $ $ $ $

HUBZone SB $ $ $ $

VOSB $ $ $ $

SDVOSB

ABILITYONE $ $ $ $

PERCENTAGES

(of total contract value)

OTS Business* % % % %

SB* % % % %

OTSB + SB 100 % 100 % 100 % 100 %

SDB % % % %

WOSB % % % %

HUBZone SB % % % %

VOSB % % % %

SDVOSB % % % %

ABILITYONE % % % %

Include additional option years if applicable

* The sums of the “OTS Business” and “SB” dollars lines (excluding subcategories) must equal the associated dollar values on the “Total dollar value of this contract” line. The sum of “OTS Business” and “SB” percentage lines (again, excluding subcategories) must equal 100% and represent all work to be performed under the contract.