ATTACHMENT J.docx

CHEGAR SOL_72065620R00001

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

SECTION J – LIST OF ATTACHMENTS

ATTACHMENT J.1 – MONITORING, EVALUATION AND LEARNING (MEL) PLAN [to be included at award, form attached]

ATTACHMENT J.2 - SUMMARY BUDGET FORMAT (TEMPLATE) [Please note that Attachment J.2. - summary budget format (template) is provided as a sample only. Offerors are not obligated to use the Attachment J.2 to prepare their budget and/or may edit the template as necessary to suit their needs.]

ATTACHMENT J.3 - PAST PERFORMANCE QUESTIONNAIRE

ATTACHMENT J.4 – WORK PLAN TEMPLATE

ATTAHCMENT J.5 – PERFORMANCE INFORMATION

[END OF SECTION J]

image2.emf

ATTACHMENT J.2 - BUDGET FORMAT TEMPLATE.pdf.xlsx Total Summary

CHEGAR

72065620R00001

USAID CHEGAR

January 1, 2020

SUMMARY BUDGET

Cost Category Year 1 Year 2 Year 3

I. SALARIES

II. FRINGE BENEFITS

III. ALLOWANCES

IV. TRAVEL AND TRANSPORTATION

V. EQUIPMENT

VI. SUPPLIES

VII. OTHER DIRECT COSTS

VIII. SUB AWARDS

SUBTOTAL DIRECT COSTS

IX. INDIRECT COSTS

TOTAL $0 $0 $0

- 0 image3.emf

ATTACHMENT J.3 - PAST PERFORMANCE INFORMATION.pdf.docx SOL -72065620R00001 Commodities for Health: Ensuring Guaranteed Access & Reliability (CHEGAR)

ATTACHMENT J. – PAST PERFORMANCE INFORMATION

CONTRACTOR PERFORMANCE REPORT - SHORT FORM

PART I: Contractor Information (to be completed by Prime)

1. Name of Contracting Entity:

2. Contract Number

3. Contract Type

4. Contract Value (TEC): (if subcontract, subcontract value)

5. Contacts: (Name, Telephone Number and E-mail address)

6a. Contracting Officer:

6b. Technical Officer (COR)

6c: Other

7. Contractor

8.Information provided in Response to RFP No.:

PART II: Performance Assessment (to be completed by Agency)

1. Quality, including overall performance to accomplish logistic planning, success in meeting quality objectives and consistency in meeting goals and targets.

2. Cost control, including forecasting costs as well as accuracy in financial reporting.

3. Schedule., including the timeliness against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g. efforts that contribute to or effect the schedule variance).

4. Management, addressing the history of professional behavior and overall business-like concern for the interest of the customer, including the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts, cooperative attitude in remedying problems, and timely completion of all administrative requirements, management of key personnel, including appropriateness of personnel for the job and prompt and satisfactory changes in personnel when problems with clients where identified.

5. Regulatory compliance, including compliance with all terms and conditions in the awards relating to applicable regulations and codes (financial, environmental, safety, and other reporting requirements).

6. Utilization of local organizations, for prime offerors who are not local organizations, their utilization of local organizations as subcontractors, including efforts in achieving local organization participation goals.

7. Other

[Note: The actual dollar amount of subcontracts, if any, (awarded to the Prime) must be listed in Block 4 instead of the Total Estimated Cost (TEC) of the overall contract. In addition, a Prime may submit attachments to this past performance table if the spaces provided are inadequate; the evaluation factor(s) must be listed on any attachments.] image4.emf

F-Work-Plan-Template.xlsx Work Plan Template

Attachment F: WORK PLAN TEMPLATE

Instructions:

The Phase II Work Plan Template should elaborate on the project activities presented in the Phase I LOI (Section 3. Project Objectives, Activities and Results) and provide more specific details on results. For an illustrative example of a complete table, please refer to tab 2 "Example." All applicants must complete the table below by following each step:

1) Input your objectives, associated activities and results.

2) Indicate when your activities will occur by placing an X in the relevant months. You can adjust the months listed to fit your estimated project schedule as needed; however, applicants should note that these dates may be subject to change during Phase III. Please note the anticipated duration of your activities in the Duration column.

3) List the results of your activities in the Results column and use BOLD font to indicate the most important results your project will produce. Examples of results include: 100 children screened, five training events held, 100 surgeries performed, 500 spectacles distributed, one national working group established, or one manuscript submitted.

Result/Solution(s) Actions/Activities Results/Outputs Year 1 Year 2 Estimated Cost

Location

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

Result 3:

Result 3:

Example

Attachment F: WORK PLAN TEMPLATE

Illustrative Example:

Note that the example below is intended to provide guidance. Applicants should provide unique activities and results based on their own project objectives.

Objective(s)/Solution(s) Actions/Activities Results Year 1 Year 2

Duration

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

Increase outreach campaigns for National Central Hospital’s Children’s Eye Health Tertiary Facility Prepare for Screenings

- Seventy Key Informants (KI) recruited.

- Thirty other volunteers and clinical workers recruited.

- Personnel trained in 2 hour-long courses per participant over three months.

100 KIs, other volunteers, and clinical staff trained and prepared to conduct outreach 4 months x x x x

Conduct Screenings -Screen 12,000 children completed over one year.

-Record date for the outcome of each screening and examination (if required). 1,200 children identified with visual impairment and given proper referral 10 months x x x x x x x x x x

Provide Treatment -Dispense spectacles to eight hundred (800) children.

-Provide sight-saving surgery to forty (40) children as confirmed at National Central Hospital.

-Provide services to One hundred and twenty (120) children, including rehabilitation and education for low vision and blind children and surgeries as confirmed by National Central Hospital and local partner Blind School. Eighty percent (80% ) of children referred receive appropriate services (960 children) 16 months x x x x x x x x x x x x x x x x

Project Close-out -Final data collected and cleaned -Complete final report -Review lessons learned Final data consolidated and all activities recorded. 2 months x x image5.emf

ATTACHMENT J.5 solicitation_template_for_contractor_performance_information.docx

Bureau for MANAGEMENT (M) office of Acquisition and Assistance

Templates Series

Solicitation Template for Contractor Performance Information

(Sections L and M)

February 2018

SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO

OFFERORS OR RESPONDENTS:

(XXX) CONTRACTOR PERFORMANCE INFORMATION [See Section M.XXX.] [CO must insert subsection number here and in paragraph (d)(2).]

(a) The offeror (including all partners of a joint venture) must provide performance information for itself, the contractor teaming arrangements, if any, and each major subcontractor (one whose proposed cost exceeds __% [CO must insert a percentage if “major subcontractor” is not defined elsewhere in the solicitation.] of the offeror’s total proposed cost) in accordance with the following:

1. List in an annex to the technical proposal up to __ [CO to insert a reasonable number Note: for high-risk contracts and orders, as defined in Appendix II and described in Appendix V of this manual, offerors must provide at least three to five references of recently completed contracts or orders] of the most recent and relevant contracts* for efforts similar to the work in the subject proposal. The most relevant indicators of performance are contracts of similar size, scope, and complexity __________________________________________________________

[CO must define relevancy based on input from the program office and add as necessary (e.g., contract types, type of work, scope of work, complexity/diversity of tasks, magnitude of effort; skills/ expertise required, location of work to be performed, required levels of technology; nature of the business area(s) involved, etc.) and how recently they were performed.]

2. For all contracts listed above that are not in CPARS, provide a list of contact names, job titles, mailing addresses, phone numbers, e-mail addresses, explanation of relevance to the proposed acquisition and a description of the performance to include:

• Scope of work or complexity/diversity of tasks,

• Primary location(s) of work,

• Term of performance,

• Dollar value, and

• Contract type, i.e., fixed-price, cost reimbursement, etc.

[For any high-risk award, as defined in Appendix II of this guidance, CO must also request point of contact information for the CO, COR, or Project Manager of the offeror’s two largest, most recently awarded Federal contracts or orders. Please refer to Appendix V for more details.]

(USAID recommends that you alert the contacts that their names have been submitted and that they are authorized to provide performance information concerning the listed contracts if and when USAID requests it.)

(b) If extraordinary problems impacted any of the referenced contracts, provide a short explanation and the corrective action taken (FAR 15.305(a)(2)).

(c) Describe any quality awards or certifications that indicate exceptional capacity to provide the service or product described in the statement of work. This information is not included in the page limitation.

(d) Performance in Using Small Business (SB) Concerns (as defined in FAR 19.001)*.

(1) This section (d) is not applicable to offers from small business concerns.

(2) As part of the evaluation of performance in Section M.XX [CO to provide section number] of this solicitation, USAID will evaluate the extent you used and promoted the use of small business concerns under current and prior contracts. The evaluation will assess the extent small business concerns participated in these contracts relative to the size/value of the contracts, the complexity and variety of the work small business concerns performed, and compliance with your SB subcontracting plan or other similar small business incentive programs set out in your contract(s).

(3) In order for USAID to fully and fairly evaluate performance in this area, all offerors who are not small business concerns must do the following:

(A) Provide a narrative summary of your organization's use of small business concerns over the past three years. Describe how you actually use small businesses--as subcontractors, as joint venture partners, through other teaming arrangements, etc. Explain the nature of the work small businesses performed--substantive technical professional services, administrative support, logistics support, etc. Describe the extent of your compliance with your SB subcontracting plan(s) or other similar SB incentive programs set out in your contract(s) and explain any mitigating circumstances if goals were not achieved.

(B) To supplement the narrative summary in (A), provide a list of the recent contracts [CO to establish the number of “recent” contracts and/or the timeframe for “recent” while keeping in mind that the number of reports could be significant over an extended period of time] for which you submitted subcontract reports to eSRS (FAR 52.219-9(d)(10) and a copy of any similarly recent subcontracting reports if they were not submitted to eSRS.

(C) Provide the names and addresses of three SB concerns for us to contact for their assessment of your performance in using SB concerns. Provide a brief summary of the type of work each SB concern provided to your organization, and the name of a contact person, his/her title, phone number, and e-mail address for each.

[End of Section L provision]

*Required for all USAID solicitations other than personal services contracts, 100 percent small business set asides, and those for which a justification for other than full and open competition has been approved.

SECTION M - EVALUATION FACTORS FOR AWARD:

(XXX) CONTRACTOR PERFORMANCE INFORMATION _XX_

[CO must insert number of points, if using a point scoring system. See FAR 15.305(a)(2) for required elements and section 4.1.5 of this guidance on determining the relative weight for CPI. Note: Per ADS 302.3.6.3, the expected weight range for CPI is 20-30% of the total non-cost evaluation criteria. ] [See Section L.XXX.] [CO must insert subsection number here and in paragraph (a).]

(a) Performance information will be used for both the responsibility determination and best value decision. USAID may use performance information obtained from other than the sources identified by the offeror/subcontractor. USAID will utilize existing databases of contractor performance information and solicit additional information from the references provided in Section L. [XXX ] of this RFP and from other sources if and when the Contracting Officer finds the existing databases to be insufficient for evaluating an offeror’s performance.

(b) Adverse past performance information to which the offeror has not previously had an opportunity to respond will be addressed in accordance with the policies and procedures set forth in the FAR 15.3.

(c) USAID will initially determine the relevance of similar performance information as a predictor of probable performance under the subject requirement. USAID may give more weight to performance information that is considered more relevant and/or more current.

(d) The contractor performance information determined to be relevant will be evaluated in accordance with the elements below [CO to insert number of points, if using a point scoring system. For adjectival or other rating systems, indicate the order of importance of the subcriteria below or how the weighting of the elements relate to each other. The optional “ degree of relevancy” under the last subcriteria “Other” may be given more weight than other subcriteria]:

(1) Quality, including overall performance to accomplish logistic planning, success in meeting quality objectives and consistency in meeting goals and targets. _XX_

(2) Cost control, including forecasting costs as well as accuracy in financial reporting (Note to COs: this element is not required for Firm-Fixed Price or Firm-Fixed Price with

Economic Price Adjustment contracts). _XX_

(3) Schedule, including the timeliness against the completion of the contract, task orders, milestones, delivery schedules, and administrative requirements (e.g., efforts that contribute to or affect the schedule variance). _XX_

(4) Management, addressing the history of professional behavior and overall business-like concern for the interests of the customer, including the contractor’s history of reasonable and cooperative behavior (to include timely identification of issues in controversy), customer satisfaction, timely award and management of subcontracts, cooperative attitude in remedying problems, and timely completion of all administrative requirements, management of key personnel, including appropriateness of personnel for the job and prompt and satisfactory changes in personnel when problems with clients where identified. _XX_

(5) Regulatory Compliance, including compliance with all terms and conditions in the awards relating to applicable regulations and codes

(financial, environmental, safety, and other reporting requirements). _XX_

(6) Utilization of Small Business, for prime offerors who are not small business concerns, their utilization of Small Business concerns as subcontractors, including efforts in achieving small business participation goals. [Note to COs: This element is not required for

100% small business set aside, competitions limited to local organizations or purchases with an approved J&A or PSC contracts.

[See section 4.1.1 of this Mandatory Reference for guidance] _XX_

(7) Other. [As discussed in the CPARS Guidance at https://www.cpars.gov/pdfs/CPARS-Guidance.pdf and Section

3.5.1 of 302mbh, Policy Guide for Assessment and Use of Contractor Performance and Integrity Information.

Example: Degree of Relevancy - see

ADS 300mae, Source Selection Plan Guidance and Template for further information.] _XX_

Total Weight for Performance Evaluation XX_

(f) An offeror’s performance will not be evaluated favorably or unfavorably when:

(1) The offeror lacks relevant performance history,

(2) Information on performance is not available, or

(3) The offeror is a member of a class of offerors where there is provision not to rate the class against a sub factor.

When this occurs, an offeror lacking relevant performance history is assigned a "neutral" rating. [CO to identify the approach that will be used to evaluate offerors with no relevant CPI. See FAR 15.305(a)(2)].

For example, an offeror without relevant performance will be evaluated as follows: If this evaluation factor is worth a possible 20 points out of a total possible point value of 100 for the technical proposal, then this offeror’s technical proposal will have a maximum of 80 possible points. If it was assigned a total score of 70 points out of the 80 maximum possible points, its total technical score for evaluation against the other offerors would be 87.5 (i.e., 70/80). USAID understands that there may be minor arithmetic differences in percentage terms as a result; however, it considers these differences to be minor and that they will not impact any best-value decision made under this solicitation.

Prior to assigning a "neutral" past performance rating, the contracting officer may take into account a broad range of information related to an offeror's performance.

[End of Section M provision] image1.emf

ATTACHMENT J.1 MONITORING, EVALUATION AND LEARNING PLAN (MEL).doc

Monitoring, Evaluation and Learning Plan (MELP)

USAID/ List name of IP

List title of Activity

USAID LIST NAME OF ACTIVITY

ACTIVITY

monitoring, evaluation and Learning plan (MELP)

AWARD No. lxxx

Table of CONTENTS

I. Introduction

II. THE ACTIVITy’s LOGICAL FRAMEWORK

III. MONITORING AND EVALUATION PLAN

A. Responsibility for Performance Indicator Data Collection

B. Types of Indicators

C. Evaluation Activities and Special Studies

D. CLA Plan

E. Review and Updating of MEL Plan

Annex A: Performance Indicator Reference Sheets

Annex B: Performance INDICATOR MATRIX

Acronyms list any acronyms here

I. introduction

The list name of activity is a USAID/Mozambique funded intervention to support provide explanation.

This document presents list the name of activity’s Monitoring Evaluation and Learning Plan (MEL). Developing the MEL is the first step in performance management, and the plan is an integral part of activity management. Per ADS 201 policy guidelines, implementers must submit an activity ME plan to the COR/AOR within the first 60 or 90 days of the award (depends what is written in the contract). Data collection, analysis, and feedback are a critical part of performance monitoring and tell the partner staff, USAID, and other stakeholders whether the activity is achieving its objectives. The MEL:

· Serves as a dynamic vehicle for self-assessment.

· Enables t decision-making

· Establishes baseline information to be used in measuring activity results.

· Provides USAID with transparent and reliable data required for its quarterly program monitoring responsibility and for annual reporting on program performance to Washington.

· Requires minimal financial and staff resources by being integrated into normal operational systems.

The design and implementation of the MEL for the list name of activity is the responsibility of list names. Actual day to day implementation of the Plan is the responsibility of list name/s of the list the activity team.

II. THE ACTIVITy’s LOGICAL FRAMEWORK

Activity MEL plans should include already defined indicators that flow from the PAD's MEL Plan as outlined in USAID’s Activity Approval Document. Per ADS201, USAID/Mozambique provides the implementing partner with information on key results, to which the activities are expected to contribute. Thus, the current Activity MEL Plan articulates the linkage between activity-level indicators and the Project Approval Document/IR level indicators.

The current activity will accomplish the following key outputs: [Describe how activity-level outputs will achieve Activity-level outcomes and/or purpose of the activity].

Sample Activity Logical Framework

Narrative Summary

Indicators

Data Sources

Assumptions

Activity Purpose

Outcome

Output

Input

III. MONITORING AND EVALUATION PLAN

A. Responsibility for Performance Indicator Data Collection

Activity implementation and the collection and reporting of performance indicator data, is the overall responsibility of List person/s that will be responsible for collecting and compiling the performance data from all program/activity participants.

Further, briefly explain roles and responsibilities in your MEL system.

B. Types of Indicators

Activity MEL Plans may include quantitative and/or qualitative indicators. For qualitative indicators, activity MEL Plans may include milestones—which measure progress towards a desired outcome by dividing the progress into a series of steps. The activity MEL Plan should include all the entire set of indicators an implementing partners uses for managing the activity. Annex A contains the Performance Indicator Reference Sheet for each indicator. Annex B provides overview information of targets and actuals for each indicator for the entire activity’s lifetime. The MEL Plan at a minimum must include all required indicators related to funding streams, initiatives, and Mission PMP requirements.

C. Evaluation ActivitIEs and Special Studies

Please explain plans for evaluations and special studies during the activity life cycle by filling out the sheet below:

Evaluation/Study Subject

Timeframe for Evaluation

Key Research Question(s)

D. CLA PLAN

The CLA section in the MEL plan should address the following four elements: Collaboration, Gaps in knowledge, Plans to pause and reflect on progress made and resource for CLA.

The IP may consider including these types of activities and processes in the CLA section, as appropriate:

Strategic Collaboration

• Coordinating site visits among implementing partners and other stakeholders to encourage collaboration.

• Facilitating implementing partners’ efforts to collaborate and share information with each other through joint work planning sessions or other means learning.

Learning

• Developing learning agendas or questions around critical knowledge gaps at the project or activity level.

• Identifying trends or changes in the context that could impact the Activity and processes for tracking and responding to them.

• Participate in knowledge sharing forums, such as communities of practice and learning networks.

Reflection to Inform Adaptation

• Planning for facilitated reflection sessions with local stakeholders to regularly gather information on context changes.

• Instituting reflection opportunities to consider new learning, shifting priorities, and necessary adaptations.

Each activity or process listed in the plan should include information on:

● Roles and Responsibilities - Which staff member will be responsible for leading the activity or process?

● Expected Outcomes - What is the intended outcome for each action item? What will change as a result of implementing the identified process or activity?

● Timeline - What are the key milestones and/or deadlines for the action items?

● Resources - What resources (including staff time, mechanisms, funding, etc.) will be used to implement the action item?

● Next steps - What is the first step to be taken in implementing this action?

E. Review and Updating of MEL Plan

The MEL Plan may need to be updated due to performance issues, changes in USAID/Washington mandated performance indicator reporting requirements, specific reporting requirements associated with use of specially earmarked funding for the program, significant changes in the economic and political context that modifies program implementation prospects, or modifications in anticipated USAID life of program funding allocations.

Annex A: Performance Indicator Reference Sheets

COMPLETE A SHEET FOR EACH INDICATOR AT THE ACTIVITY LEVEL

PERFORMANCE INDICATOR REFERENCE SHEET

Development Objective: Enter the title of the Development Objective the activity supports.

Intermediate Result: Enter the title of the Intermediate Result the activity supports

Sub-Intermediate Result: Enter the title of the Sub-IR the activity supports

Performance Indicator: Enter the title of the performance indicator

DESCRIPTION

Precise Definition (s): Define the indicator more precisely. Define specific words or elements in the indicator as necessary

Unit of Measure: Enter the unit of measure (e.g….number of…percentage of…US Dollars)

Disaggregated by: List planned data disaggregation (male/female, youth/adults, rural/urban, region etc.)

Justification/Management Utility: Briefly describe why this particular indicator was selected and how it will be useful for managing performance of the SO team’s portfolio

Indicator’s Relevance to Gender: Briefly explain whether and how this indicator has any relevance to gender

PLAN FOR DATA ACQUISITION

Data Collection Method: Describe the tools and methods by which the data will be collected

Data Source (s): Identify who is responsible for providing the data to your organization (name of partner organization

Frequency/Timing of Data Acquisition: Describe how often the data will be collected

DATA QUALITY ISSUES

Date of initial Data quality Assessment: Enter the date of the initial data quality assessment

Know Data Limitations and Significance (if any): Describe any data limitations or weaknesses discovered during data quality assessment

Actions Taken or Planned to Address Data Limitations: Describe planned actions, if any, to address limitations and weaknesses

Data of Future Data Quality Assessments: List the date of next planned data quality assessment

PLAN FOR DATA ANALYSIS, REVIEW, & REPORTING

Data Analysis: Describe how the raw data will be analyzed, who will do it, and when

Presentation of Data: Describe how tables, graphs or charts or other similar tools will be used to present data

Review of Data: Describe when and how the management team will review the data

Reporting of Data: Describe when and how and by whom this data will be reported to USAID/Mozambique

Annex B: Performance INDICATOR MATRIX

List date

This publication was produced for review by the United States Agency for International Development.

PAGE

Year 1

Indicator Baseline Q 1 Q2 Q 3 Q 4 Y 1

Target Actual Target Actual Target Actual Target Actual Target Actual

Year 2

Indicator Baseline Q 1 Q2 Q 3 Q 4 Y 1

Target Actual Target Actual Target Actual Target Actual Target Actual

Year 3

Indicator Baseline Q 1 Q2 Q 3 Q 4 Y 1

Target Actual Target Actual Target Actual Target Actual Target Actual

Year 4

Indicator Baseline FY? FY?

Target Actual Target Actual

#1

#2

#3

#4

#5

#6

#7

Year 5