Att._9_Proposal_Submission_Package.docx

SOLICITATION P16OS00037: ATTACHMENT #5

PROPOSAL SUBMISSION PACKAGE

5/26/15

INSTRUCTIONS: The following forms should be used to prepare proposals for the subject solicitation as applicable.

CONTENTS:

1. Past Performance Questionnaire

2. Proposed Equals

3. Hazardous Materials Identification Listing

4. General References

PAST PERFORMANCE QUESTIONNAIRE

I. CONTRACT IDENTIFICATION

CONTRACTOR ADDRESS:

CONTRACT TYPE:

[ ] FIRM-FIXED-PRICE

[ ] COST REIMBURSEMENT

[ ] OTHER____________________________

[ ] ACTIVE [ ] COMPLETED

[ ] ROUTINE [ ] COMPLEX

TOTAL WITH MODS $___________________

PROJECT DESCRIPTION:

II. AGENCY (CUSTOMER) IDENTIFICATION

AGENCY/CLIENT (CUSTOMER) NAME:

TITLE/PHONE:

III. PAST PERFORMANCE RATING

2. TIMELINESS:

3. BUSINESS RELATIONS:

IV. COMMENTS

Provide any additional comments for items in Section III

POC SIGNATURE/DATE:

Please provide contact information where you may be reached during normal business hours:

PROPOSED EQUALS

In accordance with provision 52.211-06, the following products are being proposed as equals. Provide all attachments required by the provision, as applicable. Use additional sheets of paper as necessary.

B. The Contractor is encouraged to submit for approval products that exceed accessibility standards, are sustainable and/or made from recycled or environmentally responsible material. Every effort will be made to approve these materials.

HAZARDOUS MATERIALS IDENTIFICATION LISTING

In accordance with Clause 52.223-3, Hazardous Material Identification and Material Safety Data, of the Contract, contractor is required to identify any hazardous materials that will be delivered under this contract.

List below all known hazardous materials to be used in performance of the work and submit with the proposal/bid. If material components are unknown at the time of submission, respond with a statement to that effect.

General References READ CAREFULLY: The purpose of this form is for the offeror to provide the Government with general references in the spaces provided. Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their relationships with the references may be considered less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s past performance record. Provide explanations on separate sheets as necessary.

Name of Contractor/Offeror:

Surety

Name of Surety:

Address of Surety:

Name of Agent:

Telephone Number:

Corporate Bank

Name of Bank:

Address of Bank:

Name of Agent:

Telephone Number:

Types and Numbers of Accounts:

Corporate Bank

Name of Bank:

Address of Bank:

Name of Agent:

Telephone Number:

Types and Numbers of Accounts:

Insurance Company

Name:

Address:

Name of Agent:

Telephone Number:

Types of Policies:

Subcontractor

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

Subcontractor

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

Subcontractor

Name:

Address:

Name of Contact:

Telephone Number:

Area of Specialized Work:

Material Supplier

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material:

Material Supplier

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material:

MATERIAL Supplier

Name:

Address:

Name of Contact:

Telephone Number:

Types of Material: