NASF Exhibit A-D.pdf

Base Operations Support Contract (BOSC) N62473-23-R-3218 Naval Air Station Fallon (NASF), NV

EXHIBIT A

FINANCIAL QUESTIONNAIRE

SOLICITATION NO: N62473-23-R-3218

(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 secure email to christopher.j.jennen.civ@us.navy.mil and christine.a.roundy.civ@us.navy.mil. The requested information must be received by the contractor no later than: OCT. 01, 2024 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

EXHIBIT B

FACTOR 1 - CORPORATE EXPERIENCE

SOLICITATION NO: N62473-23-R-3218

This form is to be completed by the Offeror. Use this form (one per project) to provide supporting project information for Factor 1, Corporate Experience.

1. Offeror Name:

JV Partner Name: (if applicable) Mentor Protégé JV (if applicable)

First-Tier Small Business Subcontractor Name: (if applicable) Sub-annex 1604000 Wastewater Subcontractor 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):

Funded Period of Performance:

Project is _______% complete

4. Award Amount (including all options):

Final Contract Price (including all options):

Total Annual Contract Value (see definition):

Amount billed/invoiced: $ _____________

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 First-Tier Small Business Subcontractor Sub-annex 1604000 Wastewater Subcontractor

**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 in Block 9.

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/Sub-Annex Number and Name Contract

Price

Percentage of work your Firm self-performed

Yes - or - No

Sub-annex 0501040 Ground Electronics $ %

Sub-annex 0501050 Airfield Facilities $ %

Sub-annex 0501070 Passenger Terminal and Cargo Handling

Sub-annex 0501080 Aviation Ground Support Equipment

Sub-annex 1501000 Facility Management $ %

Sub-annex 1502000 Facility Investment $ %

Sub-annex 1503010 Custodial $ %

Sub-annex 1503020 Pest Control $ %

Sub-annex 1503030 Integrated Solid Waste Management

Sub-annex 1503040 Swimming Pools $ %

Sub-annex 1503050 Grounds Maintenance and Landscaping

Sub-annex 1503060 Pavement Clearance $ %

Sub-annex 1601000 Utilities Management $ %

Sub-annex 1602000 Electrical $ %

Sub-annex 1630000 Natural Gas $ %

Sub-annex 1604000 Wastewater $ %

Annex 1700000 – Base Support Vehicles and Equipment

Annex 1800000 – Environmental $ %

All Others $ %

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

$ 100 %

EXHIBIT C

FACTOR 2- PAST PERFORMANCE

SOLICITATION NO: N62473-23-R-3218

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 Subcontractor 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) 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)?

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)

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.

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

FACTOR 5 - SAFETY DATA & NARRATIVE

SOLICITATION NO: N62473-23-R-3218

This form is to be completed by the Offeror. Use this form to provide safety information for the Safety factor. DART rates and TCR shall not be submitted for subcontractors, except as noted (in Factor 1 – Corporate Experience) for Small Business Offerors utilizing first-tier Small Business subcontractor experience.

Joint Venture (JV) or Partnership: Complete Blocks 1 through 3 for each business entity who is part of the JV or partnership. Small Business Offerors utilizing first-tier Small Business subcontractor experience: Complete Blocks 1 – 3 for the Small Business Offeror and each first-tier Small Business subcontractor. For Offerors utilizing Sub-annex 1604000 Wastewater Subcontractor experience:

Complete Blocks 1 – 3 for the Offeror and the Sub-annex 1604000 Wastewater Subcontractor.

1. Offeror Name:

Name of JV member, partner, first-tier Small Business subcontractor, or Sub-annex 1604000 Wastewater Subcontractor providing the information below (if applicable):

Offeror’s Five 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. U.S. Dept. of Labor, OSHA Days Away from Work, Restricted Duty, or Job Transfer (DART) Rate

2019 2020 2021 2022 2023

Instructions for calculating the DART rate can be found in the solicitation.

2a. For DART Rates of 3.0 or greater, explain any extenuating circumstances and corrective actions taken:

2b. Explain any negative DART Rate trends and any corrective actions taken for improvement:

2c. If you do not have a DART Rate for a given year, state so here and explain why:

3. U.S. Dept. of Labor, OSHA Total Case Rate

(TCR)

2019 2020 2021 2022 2023

Instructions for calculating the TCR can be found in the solicitation.

3a. For TCR of 4.5 or greater, explain any extenuating circumstances and corrective actions taken:

3b. Explain any negative TCR trends and any corrective actions taken for improvement:

3c. If you do not have a TCR for a given year, state so here and explain why: