PAS Attachment 2 Determination of Responsibility Document.docx

DETERMINATION OF RESPONSIBILITY DOCUMENT

Prospective Contractor:

Solicitation No.: W50S8A-21-B-5202

Project Title: Repair Main Gate

The following information is provided to assist the Contracting Officer in determining whether or not the proposed contractor meets the general standards of responsibility enumerated at FAR 9.104-1 and DFARS 209.104-1.FAR 9.104-1 General Standards. To be determined responsible, a prospective contractor must:

(a) HAVE ADEQUATE FINANCIAL RESOURCES TO PERFORM THE CONTRACT, OR THE ABILITY TO OBTAIN THEM (SEE 9.104-3(b))

1. Provide a copy of your latest Financial Statements (Income Statement and Balance Sheet) of your company. If the financial statement is older than one year, please furnish a statement as to the current status of the company.

2. Banking References: Provide signed reference on letterhead from the financial institution supporting each banking reference. Please provide the following information in this letter:

Bank's name Address and Telephone number Reference Name and Title Length of time with bank Credit Rating Number/type of accounts Amount in each account (# of figures) Credit line: Secured/Unsecured Outstanding loans: Secured/Unsecured

(b) BE ABLE TO COMPLY WITH THE REQUIRED OR PROPOSED DELIVERY OR PERFORMANCE SCHEDULE, TAKING INTO CONSIDERATION ALL EXISTING COMMERCIAL AND GOVERNMENTAL BUSINESS COMMITMENTS

1. Please complete the document titled Pre-Award Survey Questionnaire

***Please see next page***

(c) HAVE A SATISFACTORY PERFORMANCE RECORD (SEE 9.104-3(c) and Subpart 42.15)

1. Please complete the enclosed form titled Construction Contractor Experience Data. Use separate sheets for detailed descriptions of items reported.

2. For all contracts listed in the Construction Contractor Experience Data form under “Recent Government Contracts Performed,” please provide the following information (if CPAR reports are available, these reports can be submitted in lieu of these items):

Agency Name Address and telephone number for the reference Reference Name and Title Location and type of work Project Amount Contract Completion Date and Actual Completion Date Percentage of Work Completed Explain if the project was completed on budget Explain the quality of work Management cooperativeness Any problems encountered and how they were resolved

(d) HAVE A SATISFACTORY RECORD OF INTEGRITY AND BUSINESS ETHICS

1. Trade References: Please provide the following information from your Trade References

Company Name Address and Telephone # Reference Name and Title Length of time with company Average monthly business High credit Payment history Takes discounts

***Please see next page***

(e) HAVE THE NECESSARY ORGANIZATION, EXPERIENCE, ACCOUNTING AND OPERATIONAL CONTROLS, AND TECHNICAL SKILLS, OR THE ABILITY TO OBTAIN THEM (INCLUDING, AS APPROPRIATE, SUCH ELEMENTS AS PRODUCTION CONTROL PROCEDURES, PROPERTY CONTROL SYSTEMS, QUALITY ASSURANCE MEASURES, AND SAFETY PROGRAMS APPLICABLE TO MATERIALS TO BE PRODUCED OR SERVICES TO BE PERFORMED BY THE PROSPECTIVE CONTRACTOR AND SUBCONTRACTORS) (SEE 9.104-3(b))

1. Please provide your Workman's Compensation Experience Modification Rate (EMR) for the following years:

2019 and 2020

*An EMR greater than 1.0 must be explained and supported documentation provided.

(If EMR’s are not available, provide documentation from insurance provider documenting whether or not any claims resulting from work related injuries have been filed against the firm in the last three years or any other documentation that could be used to establish safety record.)

(f) HAVE THE NECESSARY PRODUCTION, CONSTRUCTION, AND TECHNICAL EQUIPMENT AND FACILITIES, OR THE ABILITY TO OBTAIN THEM (SEE 9.104- 3(b))

1. Please complete the document titled Pre-Award Survey Questionnaire and,

2. Please complete the enclosed form titled, Construction Contractor Experience Data. Use separate sheets for detailed descriptions of items reported.