MDR_RFQ_Attachments.doc

WHS AD Solicitation # RC051920150146 -- Attachments

Attachment 1 Past Performance Questionnaire

Your assistance is requested by the Acquisition Directorate for Washington Headquarters Services with establishing the performance history for the contractor named below for use in evaluation of solicitation RC051920150146. Please complete this questionnaire and email to: robin.castoldi.civ@mail.mil by June 18, 2015 by 10:00 AM EDT When Complete, the information on this form is Source Selection Sensitive (41 USC 423): SAFEGUARD.

Contractor Name & Address:

Contract No.:

Contract Award Date:

Place of Performance:

Completion Date:

Contract Value:

Type of Contract:

Evaluator Name/Title/Phone:

Description of Contract Requirements:

Evaluation: Please provide comments, in the remarks section, for any “No” answer as well as any rating of Marginal (2) or Unsatisfactory (1)

*Ratings Categories: 1-Unsatisfactory, 2-Marginal, 3-Satisfactory, 4-Very Good, 5-Exceptional, N/A-Not Applicable

1. Quality of Performance

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2. Timeliness

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No FORMCHECKBOX

3. Business Relations

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Would you recommend the award of similar contracts to this firm in the future?

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Yes

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No

*Ratings Definitions:

Exceptional: Performance meets contractual requirements and exceeds many to the Government’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 were highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the Government’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.

Satisfactory: Performance meets 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.

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.

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.

Remarks:

Has the information provided been previously shared with the Contractor-

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Yes

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No

Attachment 2

OCI ANALYSIS/ DISCLOSURE FORM

1. Solicitation Number

RC051920150146

2. Program Title

3. Contractor Name and Address

4. Telephone Number and POC

5. Type of work to be performed under this agreement:

7. Brief Summary/ Description of work performed under Block 6 action:

8. Relationship between requirements of Block 1 action and work performed under Block 6 action (If None, State Why):

9. Offeror/Contractor OCI Evaluation and Assessment (If either answer is yes, attach a copy of the SOW and complete Block 10):

(a) Does Actual OCI exist? ( ) Yes ( ) No

(b) Does Potential OCI exist? ( ) Yes ( ) No

10. Summary of actual/potential OCI, including actions planned to avoid, neutralize, or mitigate conflict or potential conflict:

11. Typed Name of Responsible Official

12. Signature

13. Date

14. Typed Name of Contracting Officer

15. Approval Signature

16. Date

INSTRUCTIONS FOR COMPLETING OCI ANALYSIS/ DISCLOSURE FORM

Blocks 1 through 5: Self explanatory

Block 6: Fill in the number and the short, official title by which the contract or subcontract is formally known. This is work that has already been awarded, is being performed by your company, and requires a comparison with the work described in Blocks 1 – 5. NOTE: One OCI Analysis/ Disclosure Form shall be submitted for EACH related contract or subcontract currently being performed.

Block 7: Provide a brief, but specific, narrative summary of the SOW and work performed on the contract or subcontract listed in Block 6, including the period of performance and the value.

Block 8: Provide a brief, but specific, narrative summary of ANY relationship between the work to be performed under the action listed in Block 1 and the previous work performed under the action listed in Block 6. Please be as specific as possible by citing the specific RFP/SOW paragraph where possible.

Block 9: Place an “X” in the appropriate ( ) for your responses.

Block 10: If you answer yes to either 9(a) or to 9(b), provide a summary of the actual or potential OCI.

Blocks 11, 12, and 13: Provide the name of your company official with the responsibility for and/or authority to discuss and commit the company on matters related to OCI issues. That official should then sign and date each form.

Attachment 3 Contract Line Item Number (CLIN) Structure

9/1/2015-8/30/2016

9/1/2015-8/30/2016

9/1/2015-2/27/2016

9/1/2016-8/31/2017

3/1/2016-8/31/2016

9/1/2017-8/31/2018

9/1/2016-2/27/2017

3/1/2017-8/31/2017

9/1/2017-2/27/2018

TOTAL:

*For purposes of determining the evaluated price for the six month 52.217-8 extension, calculations should be six-months of the total price of the final option CLIN

Source Selection Information – See FAR 2.101 and 3.104