Attachment J39 - Past Performance Questionnaire.pdf

ATTACHMENT J39

PAST PERFORMANCE INFORMATION

Provide the information requested in this form for each program being described. Provide frank, concise comments regarding your performance on the contracts you identify.

A. OFFEROR NAME (COMPANY/DIVISION) AND LOCATION (CITY/STATE):

(NOTE: IF THE COMPANY OR DIVISION PERFORMING THIS EFFORT IS DIFFERENT THAN THE

OFFEROR, OR THE RELEVANCE OF THIS EFFORT TO THE ACQUISITION IS IMPACTED BY ANY

COMPANY/CORPORATE ORGANIZATIONAL CHANGE, NOTE THOSE DIFFERENCES/CHANGES AND

EXPLAIN WHY THE PAST PERFORMANCE SHOULD BE ATTRIBUTED TO THE OFFEROR. REFER TO

THE “ORGANIZATIONAL STRUCTURE CHANGE HISTORY” YOU PROVIDED AS PART OF YOUR

RELEVANT PRESENT AND PAST PERFORMANCE VOLUME.)

B. PROGRAM TITLE:

C. CONTRACT SPECIFICS:

1. Contract Number _______________________________

2. Contract Type _________________________________________

3. Period of Performance ______________________________________

4. Original Contract $ Value ___________________________________

5. Current Contract $ Value ______________________________

If Amounts for 4 and 5 above are different, provide a brief description of the reasons for the difference

D. BRIEF DESCRIPTION OF EFFORT AS __PRIME OR __SUBCONTRACTOR.

(Please highlight portions considered most relevant to current acquisition)

E. COMPLETION DATE:

1. Original Contractual Date: ____________________

2. Current Schedule: ____________________

3. Estimated Date of Completion: ____________________

4. How Many Times Changed: ____________________

5. Primary Causes of Change: ____________________

Section J39 for Aberdeen Proving Ground

F. PRIMARY GOVERNMENT OR EQUIVALENT POINTS OF CONTACT:

(Please provide current information on all individuals)

1. Program Manager: Name: ______________________________

Office ______________________________

Address ______________________________

Telephone ______________________________

E-mail ______________________________

Fax ______________________________

2. PCO: Name: ______________________________

Office ______________________________

Address ______________________________

Telephone ______________________________

3. ACO: Name: ______________________________

Office ______________________________

Address ______________________________

Telephone ______________________________

4. COR: Name: ______________________________

(Contracting Officer Rep) Office ______________________________

Address ______________________________

Telephone ______________________________

E-mail ______________________________

G. ADDRESS ANY TECHNICAL (OR OTHER) AREA ABOUT THIS PROGRAM CONSIDERED

UNIQUE.

H. SPECIFY BY NAME ANY KEY INDIVIDUAL(S) WHO PARTICIPATED IN THIS PROGRAM AND

IS/ARE PROPOSED TO SUPPORT THE INSTANT ACQUISITION. ALSO, INDICATE THEIR

CONTRACTUAL ROLES FOR BOTH ACQUISITIONS.

I. ADDRESS PROBLEMS ENCOUNTERED ON THIS CONTRACT AND YOUR SOLUTIONS TO THOSE

PROBLEMS.

J. IDENTIFY IF A SMALL BUSINESS OR DISADVANTAGED BUSINESS PLAN OR GOAL WAS

REQUIRED. IF SO, IDENTIFY IN TERMS OF A PERCENTAGE OF THE PLANNED VERSUS ACHIEVED

GOAL DURING THE CONTRACT. IF GOALS WERE NOT MET, PLEASE EXPLAIN.

K. DESCRIBE/DISCUSS THE RELEVANCY OF THE SERVICES YOU PROVIDED ON YOUR

REFERENCED CONTRACT TO THESE QUESTIONS AS THEY MAY PERTAIN TO THE SPECIFIC

UTILITY.

General

1. Indicate (yes or no) if you owned, operated, maintained the system for the referenced customer.

Indicate if the systems were located on the customer’s site.

OWN OPERATE MAINTAIN ON SITE

Sewer Lines

Pump Stations

WWTP

Industrial WWTP

Water Lines

Water Storage Tanks

Water Treatment Plants

Above Ground Electrical Distribution System

Below Ground Electrical Distribution System

Power Generation Facility

Substations

Gas Distribution System

Wastewater System

1. What is the average daily flow (gallons per day) for the referenced system?

2. What is the capacity of the WWTP?

3. What is the capacity of the Industrial WWTP?

4. How many pump stations are operated/maintained?

5. How many linear feet of sewage lines are maintained?

6. What is the dollar value of the capital improvements you made to the system during the total period of time service has been rendered?

Time_____(yrs) $_____

7. Have capital improvements been completed that directly or indirectly reduced the amount of Inflow/Infiltration for the system serving the referenced customer?

Capital Improvements $_____ Inflow/Infiltration Reduction_____(%)

Water System

1. What is the average daily flow (gallons per day) for the referenced customer?

2. What type of treatment occurs at the Water Treatment Plant?

3. What type of storage tanks are operated/maintained (ground/elevated, capacity)?

4. What is the dollar value of the capital improvements you made to the system during the total period of time service has been rendered?

Time_____(yrs) $_____

Electrical System

1. What is the voltage of the system you operate/maintain?

2. How many facilities are served by the system you operate/maintain?

3. What is the length (linear feet) of the overhead distribution system you operate/maintain?

4. What is the length (linear feet) of the underground distribution system you operate/maintain?

5. What is the dollar value of the capital improvements you made to the system during the total period of time service has been rendered?

Natural Gas System

1. What is the length (linear feet) of the distribution system you own/operate?

2. How many meters are on the system you own/operate?

3. What is the dollar value of the capital improvements you made to the system during the total period of time service has been rendered?