Statement of Capability Questionnaire.docx

OPERATION AND MAINTENANCE OF THE WASTEWATER TREATMENT PLANT AND INCINERATOR PLANT TO INCLUDE VARIOUS RELATED EQUIPMENT AT U.S. COMMANDER FLEET ACTIVITIES YOKOSUKA (CFAY), JAPAN

Statement of Capability Questionnaire

Company Information Name of Company: Click or tap here to enter text.

Mailing Address: Click or tap here to enter text.

CAGE Code: ☒ Yes ☐ No If Yes, enter your CAGE Code: Click or tap here to enter text.

SAM Unique Entity ID (UEID): ☐ Yes ☐ No If Yes, enter your SAM UEID Click or tap here to enter text.

Company Point of Contracts Primary POC Name of Primary: Click or tap here to enter text. Title: Click or tap here to enter text.

Email: Click or tap here to enter text.

Phone #: Click or tap here to enter text. FAX #: Click or tap here to enter text.

Alternate POC Name of Alternate: Click or tap here to enter text. Title: Click or tap here to enter text.

Email: Click or tap here to enter text.

Phone #: Click or tap here to enter text. FAX #: Click or tap here to enter text.

Technical Capability

1. Which services stated in the sources sought can your company perform? Please check the boxes that your company can perform below (check all that apply):

2. The Government is contemplating requiring the offeror to meet the following registrations/permits/licenses requirements. Please check the boxes that your company and/or your potential partner have registration/permit/license (check all that apply):

Prime contractor shall have:

☐Ordinary Construction License or Special Construction License (Machinery installation, Piping Work, and Electrical work) ☐Building Water Tank Cleaning Service Registration (Kenchikubutsu Inryousui Chosuisou Seisougyou) ☐Septic Tank Maintenance and Inspection Business Registration (Joukasou Hosyu Tenkenn-Gyou) in Yokosuka City and Kanagawa Prefecture ☐Sewage Treatment Facility Maintenance and Management Business Registration (Gesuidou Shori-sisetsu Iji-kanri Gyou)

Prime contractor/Subcontractor shall have:

☐Industrial Waste Disposal Permit (Sangyo Haikibutsu-Syori) ☐Industrial Waste Collection and Transportation (Sangyou-Haikibutsu- Syuusyuu-Unpan) (waste category: sludge or/and mixed industrial waste) ☐Special Industrial Waste Collection and Transportation (Tokubetsu Sangyou-Haikibutsu-Syuusyuu-Unpan) ☐Special Industrial Waste Disposal (Tokubetsu Kanri Sangyo Haikibutsu-Syori)

If you have suggestions to remove and/or add registrations/permits/licenses requirements, please provide the name of registrations/permits/licenses and its reason.

Click or tap here to enter text.

Experience

3. Please list up to three (3) contracts your company is currently performing that would be considered the same as or similar to this effort (size, scope, complexity), as well as those you have completed within the last five years.

Contract #1

(a) Name of Contracting Activity or Customer: Click or tap here to enter text.

(b) Contract type (FFP, Cost, IDIQ, or Combination): Click or tap here to enter text.

(c) Period of Performance: Click or tap here to enter text.

(d) Basic Contract Award Amount with Options: Click or tap here to enter text.

(e) Contract Value Per Year: Click or tap here to enter text.

(f) Current/Final Contract Amount: Click or tap here to enter text.

(g) Summary of Contract Work:

Click or tap here to enter text.

(h) Contracting Officer/Customer Name and Current Telephone Number: Click or tap here to enter text.

(i) List of Major Subcontractors including name, address, and telephone number of primary point of contactClick or tap here to enter text.

Contract #2

(a) Name of Contracting Activity or Customer: Click or tap here to enter text.

(b) Contract type (FFP, Cost, IDIQ, or Combination): Click or tap here to enter text.

(c) Period of Performance: Click or tap here to enter text.

(d) Basic Contract Award Amount with Options: Click or tap here to enter text.

(e) Contract Value Per Year: Click or tap here to enter text.

(f) Current/Final Contract Amount: Click or tap here to enter text.

(g) Summary of Contract Work:

Click or tap here to enter text.

(h) Contracting Officer/Customer Name and Current Telephone Number: Click or tap here to enter text.

(i) List of Major Subcontractors including name, address, and telephone number of primary point of contactClick or tap here to enter text.

Contract #3

(a) Name of Contracting Activity or Customer: Click or tap here to enter text.

(b) Contract type (FFP, Cost, IDIQ, or Combination): Click or tap here to enter text.

(c) Period of Performance: Click or tap here to enter text.

(d) Basic Contract Award Amount with Options: Click or tap here to enter text.

(e) Contract Value Per Year: Click or tap here to enter text.

(f) Current/Final Contract Amount: Click or tap here to enter text.

(g) Summary of Contract Work:

Click or tap here to enter text.

(h) Contracting Officer/Customer Name and Current Telephone Number: Click or tap here to enter text.

(i) List of Major Subcontractors including name, address, and telephone number of primary point of contactClick or tap here to enter text.

Others

4. Would your company intend to form a Joint Venture, partnership, LLC, or subcontract portions of work to satisfy the requirements listed in this Sources Sought?

☐Yes ☐No

5. The Government is contemplating making this requirement to an 8-year contract. Is your company capable providing a proposal for an 8-year long contract? If not, please share your concerns with us.

☐Yes ☐No.

Please specify the reason. Click or tap here to enter text.

6. Please provide suggested technical proposal evaluation factors if any.

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7. Please review and provide feedback or questions/comments to improve Enclosure (1) Draft Performance Work Statement (PWS) if any.

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