Exhibit- Attachment 005 Past Performance Questions_Updated date based on RFP due date.docx

Attachment 005: Past Performance Questionnaire

W56HZV-21-R-L067 Rock Island Arsenal Museum Fabrication and Installation Please provide your candid response to the following questions. The information that you provide will be used in the awarding of federal contracts. Therefore it is important that your information be as factual and accurate as possible. If you do not have the appropriate knowledge with the company in question, please forward this questionnaire to the person who does. Upon completion of this questionnaire, please forward by electronic email to Kelsey Leonard, kelsey.d.leonard.civ@army.mil by 07 February 2022. Thank you for your assistance.

PART I - IDENTIFICATION (To be completed by the Offeror)

A. RELEVANT CONTRACT

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract/Task Order Number:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Contract Period of Performance End Date:

Forecasted or Actual Contract Completion:

Place of Performance:

Brief Description of the Relevant Contract Scope:

B. OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

FAX Number:

Address:

E-mail Address:

PART II - EVALUATION (To be completed by Respondent’s Point of Contact)

RATING SCALE & DEFINITIONS

Table 1 identifies the rating scale and descriptions. Please apply the rating that most closely matches your assessment for each area of consideration listed below. Please include a written narrative for each rating applied, utilizing the adjectival rating definition in Table 1.

Table 1

A. Technical:

1. Assess the contractor’s ability to: Fabricate and install exhibit components in a history exhibit that match the specifications in the exhibit design package.

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues, give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

2. Assess the contractor’s ability to: Work with facilities management or Department of Work staff in the modification of the building such as demolition or electrical work ensuring that no disruptions such as electrical service would occur that could adversely affect any other activities in the building.

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

3. Assess the contractor’s ability to: To fabricate and install object brackets components in a history exhibit as specified in the design package.

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

4. Assess the contractor’s ability to: To maintain the security of the objects by using gloves, lifts or any other object handling devices to install objects into the display as specified in the design package.

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

5. Assess the contractor’s ability to: To produce mockups or samples as needed for the client to review and approve prior to fabrication.

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

B. Project Schedule:

Assess the timeliness of contractor performance for Services and Product Deliverables: To what extent did the contractor adhere to the delivery schedules, on an overall basis?

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

C. Management / Business Relations:

Assess the contractor’s ability to effectively manage the Program (to include subcontractors). To what extent was the contractor effective in managing the Program, on an overall basis?

|_| Exceptional |_| Very Good |_| Satisfactory |_| Marginal |_| Unsatisfactory |_| Too soon to tell |_| Not Applicable

Comments:

For any adverse issues give your assessment of the extent to which the contractor was at fault (e.g. mostly attributable to contractor, evenly attributable to contractor and customer/end user, only somewhat attributable to contractor) and your assessment of the extent to which customer/end user was at fault (e.g. changes to the specification requirements, unrealistic or ambiguous specification requirements, etc.) or other factors beyond the control and without the fault or negligence of the contractor.

D. General Comments:

Any additional information, which your organization deems relevant or important, is welcome by our evaluation team. Please provide any other relevant or important performance information.

PART III - RESPONDENT IDENTIFICATION

Please provide a point of contact who compiled or completed this questionnaire and who, if needed, may be contacted by our evaluation team regarding the information provided in this questionnaire.

Organization:

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

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