Solicitation_Attachments_W911KF19Q0016.pdf

EVIDENCE OF AUTHORITY TO SIGN OFFERS

Reference the solicitation provision in Section I entitled “Signature Authority.” Evidence of the authority of individuals signing offers to submit firm offers on behalf of the Offeror is required except for the owner in the case of sole proprietorships. When Contractor is a corporation, complete this certificate.

CERTIFICATE OF CORPORATE OFFICIAL/AGENT’S AUTHORITY TO BIND CORPORATION

I, _________________________________, Secretary of ________________________________________

_________________________________, a corporation created and organized under the law of the State of

__________________________, do hereby certify that ___________________________ is an official/agent of said corporation and is empowered to represent, bind and execute contracts on behalf of said corporation, subject to the following limitations:__________________________________________________________.

(if none, so state)

Witness my hand and the corporate seal of said corporation this ______ day of ______________, 20____.

(CORPORATE SEAL) ________________________________________

Secretary

When Contractor is a Partnership, Unincorporated Firm or a Corporation for which completion of the first statement would be impracticable, complete this certificate:

CERTIFICATE OF AUTHORITY TO BIND PARTNERSHIP

We, the undersigned, comprising the total membership of _____________________________________________

_________________________________________________, a partnership/unincorporated firm doing business at_______________________________________________________________________, do hereby certify that ____________________________________ is a ____________________________ of said firm and is empowered to represent, bind, and execute contracts on behalf of said partnership/ unincorporated firm.

Witness our signatures, this _______ day of ________________, 20____.

Members of Partnership/Unincorporated Firm:

EPA Guideline Items (Recovered Materials Content) List

Paper and Paper Products

• Printing and writing paper

• Newsprint

• Commercial sanitary tissue products

• Paperboard and packaging products

• Miscellaneous papers

Transportation Products

• Channelizers

• Delineators1

• Flexible delineators

• Parking stops

• Traffic barricades

• Traffic cones

Vehicular Products

• Engine coolants

• Re-refined lubricating oils

• Retread tires

Landscaping Products

• Garden and soaker hoses

• Hydraulic mulch

• Lawn and garden edging

• Yard trimmings compost

• Food waste compost

• Landscaping timbers and posts

(plastic lumber) Construction Products

• Building insulation products

• Laminated paperboard

• Structural fiberboard

• Floor tiles (heavy duty or commercial)

• Patio blocks

• Carpet

• Cement and concrete containing fly ash

• Cement and concrete containing ground granulated blast furnace slag

• Shower and restroom dividers/partitions

• Consolidated and reprocessed latex paint

• Carpet cushion

• Flowable fill

• Railroad grade crossings/surfaces

Non-Paper Office Products

• Binders (paper, plastic covered)

• Office recycling containers

• Office waste receptacles

• Plastic desktop accessories

• Plastic envelopes

• Plastic trash bags

• Printer ribbons

• Toner cartridges

• Binders (solid plastic)

• Plastic clipboards

• Plastic clip portfolios

• Plastic file folders

• Plastic presentation folders

Miscellaneous Products

• Pallets

• Sorbents

• Awards and plaques

• Industrial drums

• Mats

• Signage

• Strapping and stretch wrap

Park and Recreation Products

• Plastic fencing (used for erosion control or as a safety barrier at construction sites)

• Playground surfaces

• Running tracks

• Park and recreational furniture

• Playground equipment

List reflect EPA’s changes effective as of January 2001

Refer to EPA’s Comprehensive Procurement Guideline website for recovered materials content levels – www.epa.gov/cpg.

Contractor Request for Waiver For Non-EPA Comprehensive Guideline Items1

Contract No. ______________________________

This form is to be completed by the contractor when items subject to ANAD’s Affirmative Procurement (AP) Policy are not purchased. This form is required for all contracts (including services using such items). NOTE: The Contractor must obtain signature of the Contracting Officer indicating concurrence of the waiver.

INSTRUCTIONS

1. List the EPA Guidelines item(s)1 not procured, check the appropriate justification(s), provide a written explanation and sign and date the form.

2. Obtain Contracting Officer for waiver concurrence.

3. Submit the original approved form to the Directorate of Contract and retain copy for Contractor files.

4. The Contracting Officer will provide a copy of the completed signed form to the Directorate of Risk Management Pollution Prevention Program Manager.

EPA Guideline item not purchased below (refer to EPA Guideline Items1 list):

Products containing recovered materials and meeting ANAD’s AP standards for the above EPA Guideline Items1 were not obtained because items:

_____ Do not meet all reasonable performance specifications.

_____ Are not available within a reasonable period of time.

_____ Use of minimum content standards would result in inadequate competition.

_____ Products containing recovered materials would require paying a price premium.

5. Written Justification For Not Purchasing EPA Guideline Items1 (continue on back if necessary):

Contractor Signature Date

6. CONCURRENCE ___________________________________DATE

Contracting Officer

7. DATE SUBMITTED TO THE POLLUTION PREVENTION MANAGER

1 – Also referred to as recovered material content items

CONTRACTOR AFFIRMATIVE PROCUREMENT REPORT FORM FOR

ESTIMATION OF RECOVERED MATERIAL CONTENT LEVELS

FOR EPA DESIGNATED ITEMS

(PER EXECUTIVE ORDER 13101)

CONTRACTOR: ______________________________________________

CONTRACT/DO #: ___________________________________________

BLDG # (if applicable): ________________________________________

PROJECT MANAGER: ________________________________________

INSTRUCTIONS

1. Use this form to document estimation of recovered material content levels per FAR provision 52.223-9, “Certification and Estimate of Percentage of Recovered Material for EPA Designated Items.”

2. Complete the table below for those EPA Designated Items used in performance of work under this contract/ delivery order that met or exceeded the minimum materials content levels (see 2nd column in table below).

Provide the actual recovered material content (if different from 2nd column) and quantity for these items in the appropriate column, if available.

3. Mark each line with “N/A” for those item/s not used in the performance of this contract/delivery order.

4. Note any exemptions in 5th column for each item for which a Contractor Waiver Form was previously submitted.

5. Submit to the Contracting Officer at the completion of the contract.

RECYCLED OR RECOVERED

PRODUCT

TOTAL RECOVERED

MATERIALS

CONTENT (RMC)

ACTUAL

RMC (%)

QUANTITY

USED

EXEMPTION

(1,2,3)

Rock Wool Insulation 75% Fiberglass Insulation 20-25% Cellulose loose fill/Spray-on Insulation 75% Perlite Composition Board Insulation 23% Plastic Rigid Foam Insulation 9% Plastic Foam In Place Insulation 5% Plastic Foam, Glass Fiber Reinforced Insulation

6%

Phenolic Rigid Foam Insulation 5% Structural Fiber Board 80-100% Laminated Paper Board 100% Cement/Concrete (FLYASH) See www.epa.gov/cpg High Fly Ash Flowable Fills 95% Low Fly Ash Content Flowable Fill 6-14% Carpet (PET) 25-100% Bonded polyurethane Carpet Cushion 15-50% Jute Carpet Cushion 40% Synthetic fibers Carpet Cushion 100% Rubber Carpet Cushion 60-90% Rubber Plastic Patio Blocks 90-100% Rubber or Plastic Floor Tile 90-100% Steel Restroom Divider/Partition 15% Plastic Restroom Divider/Partition 20-100% Concrete Railroad Crossing 15-20% Rubber Railroad Crossing 85-95% Steel Railroad Crossing 25-30%

BOF/100%EAF2

Traffic cones made from PVC, LDPE, crumb Rubber

50-100%

Traffic Barricades (Type I and II only) made from HDPE, LDPE, PET, steel, fiberglass

100%

TOTAL RECOVERED

MATERIALS

CONTENT (RMC)

ACTUAL

RMC (%)

QUANTITY

USED

EXEMPTION

(1,2,3)

Channelizers, Plastic 25-95% Channelizers, rubber base 100% Delineators, plastic 25-90% Delineators, rubber base 100% Delineators, steel base 25-50% Flexible plastic delineators 25-85% Parking Stops, Plastic or Rubber 100% Parking Stops, Concrete containing coal fly ash

20-40%

Parking Stops, Concrete containing Ground- Granulated Blast Furnace Slag

25-70%

Playground Surfaces, including rubber or plastic

90-100%

Plastic Fencing for use to control snow, drifting Sand, or as a safety barrier

90-100%

Running Tracks. Including rubber or plastic

90-100%

Plastic Park benches and Picnic Tables

100%

Plastic composite Park benches and Picnic Tables

100%

Aluminum Park benches and Picnic Tables

25%

Concrete Park benches and Picnic Tables

15-40%

Steel Park benches and Picnic Tables 25-30%

BOF/100%EAF

Plastics Playground Equipment 100% Plastic Composites Playground Equipment

95-100%

Steel Playground Equipment 25-30% BOF/100%

EAF

Aluminum Playground Equipment 25% Garden hose, rubber or plastic 60-65% post consumer materials

Soaker hose, rubber or plastic 60-70% post consumer materials

Lawn/garden edging, plastic or rubber 30-100% Paper-based hydraulic mulch 100% Wood-based hydraulic mulch 100% Compost Purchase or use compost made from yard trimmings, leaves, grass clippings, and food waste

100%

HDPE lumber timbers and posts 75-100% Mixed plastics/Sawdust lumber timbers and posts

100%

HDPE/Fiberglass lumber timbers and posts

95%

Other mixed resins lumber timers and posts

95-100%

Latex Paint; white, off-white or pastel colors

20%

Latex Paint; gray, brown, earth-tones, other dark colors

50-99%

TOTAL RECOVERED

MATERIALS

CONTENT (RMC)

ACTUAL

RMC (%)

QUANTITY

USED

EXEMPTION

(1,2,3)

Consolidated Latex Paint (when color and performance doesn’t matter)

100%

Plastic Non-road Signs 80-100% Aluminum Signs 25% Plastic Sign Posts and Supports 80-100% Steel Sign Posts and Supports 25-30%

BOF/100%EAF

Awards and Plaques

Glass 75-100 Wood 100% Paper 40-100 Plastic and Plastic/ Wood Composite

50-100

The following exemptions may apply to the non-procurement of recycled/recovered content materials:

1. The product is not available from a sufficient number of sources to maintain a sufficient level of competition (i. e., available from two or more sources) or is not available a reasonable price.

2. The product is not available within a reasonable period of time.

3. The product does not meet the performance standards in applicable specifications to fails to meet reasonable performance standards of the agency.

CERTIFICATION

I hereby certify the Statement of Work/Specifications for the requisition/procurement of all materials listed on this form comply with EPA standards for recycled/recovered materials content.

CONTRACTOR DATE

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

Contract Number:

1.0 INTRODUCTION

1.1. Purpose. The role of the Government in quality assurance is to ensure contract standards are achieved. The purpose of the Quality Assurance Surveillance Plan (QASP) is to identify the methods and procedures the Government will use to evaluate contractor actions while performing the requirements in the Statement of Work (SOW). It is designed to provide an effective surveillance method by monitoring contractor performance for each listed performance objective in the Performance Requirements Summary (PRS) (Section 7 of this document).

1.1.1. The QASP provides a systematic method to evaluate the services the contractor is required to perform as specified in the Statement of Work (SOW) and the Contract.

1.1.2. The QASP has been developed by the requiring activity. It is designed to provide direction to personnel performing contract surveillance activities. Personnel surveying the contract terms and conditions and SOW requirements will periodically review the QASP throughout the life of the contract.

2.0. ROLES AND RESPONSIBILITIES.

2.1. Contracting Officer Representative. The Contracting Officer Representative (COR) is responsible for quality assurance guidance and to ensure that contract quality requirements, provisions, standards, and thresholds are defined, practical, enforceable, necessary, and verifiable.

2.1.1. The COR evaluates and documents contractor performance in accordance with the QASP and SOW.

2.1.2. The COR shall notify the Contracting Officer of any significant performance deficiencies using a Contractor Discrepancy Report with supporting documentation.

2.1.3. The COR will upload copies of ALL surveillance documentation to the VCE COR Tool, unless otherwise directed by the contracting officer.

2.1.4. The COR will submit a monthly report to the contracting officer concerning performance of services rendered under this contract.

2.1.5. The COR recommends improvements to the QASP and SOW throughout the life of the contract.

2.2. Contracting Officer. The Contracting Officer is responsible for safeguarding the interests of the United States Government in contractual relationships. Only the Contracting Officer is authorized to bind the Government and then, only to the extent of the authority delegated to them through the issuance of a warrant.

2.2.1. The Contracting Officer delegates authority for inspection and/or acceptance in accordance with the terms of the contract.

2.2.2. The Contracting Officer informs the contractor of the names, duties, and limitations of authority for all quality assurance personnel assigned to the contract.

3.0. DESCRIPTION OF SERVICES

3.1. Scope of Work. From the scope:

The specification establishes the requirements for on-site preventive maintenance and emergency repair services for Government owned Strippit Equipment as specified herein. This equipment is located in buildings 145 and 451 at Anniston Army Depot (ANAD), Anniston, Alabama. The on-site preventive maintenance and emergency repair support coverage shall be for one-base year with an option of 4 additional years.

The contractor shall provide on-site preventive maintenance and emergency repair services for the Equipment listed below including all labor, equipment, special tools, materials, documentation, transportation, schematics, common tools of the trade, and any other items necessary to provide the required support as listed below.

The contractor shall follow the definition of Preventative Maintenance according to the Industry Standard EN 13306:2001. This states that Preventative Maintenance is “maintenance carried out at predetermined intervals or according to prescribed criteria and intended to reduce the probability of failure or the degradation of the functioning of an item.” Preventative maintenance shall be carried out according to Strippit specifications detailed in the equipment user manual. Only certified Strippit service technicians shall perform this maintenance.

4.0. QUALITY REQUIREMENTS

4.1. Quality Control Program. The contractor, not the Government, is responsible for management and quality control actions to meet the terms of the contract.

5.0 SURVEILLANCE. The COR will perform monthly surveillance based on the quality and effectiveness of the services provided and contractor’s data deliverables.

5.1 Unacceptable Performance. If the number of complaints/defects exceeds the performance threshold for any objective, the COR will determine the possible cause of this unacceptable performance. Government-caused complaints/defects will not be counted against the contractor. The same applies to any other requirement of the contract when Government-caused complaints/defects are the cause of unacceptable contractor performance. If the contractor’s performance is judged unacceptable for any requirement by the COR, the COR will inform the contracting officer for resolution. Significant performance deficiencies must be submitted to the Contracting Officer using a Contractor Discrepancy Report and include supporting documentation.

6.0 CONTRACTOR DOCUMENTATION REQUIREMENTS

6.1 Service document

6.2 Final Report/Invoice

7.0 PERFORMANCE REQUIREMENTS SUMMARY (PRS)

7.1 Overview. This PRS identifies the services required by the SOW over which the Government will exercise surveillance.

7.2 Performance Evaluation. Performance of a service will be evaluated to determine whether or not it meets the performance threshold. The contractor shall provide the Government a written response as to why the performance threshold was not met, how performance will be returned to acceptable levels, and how recurrence of the cause will be prevented in the future. When documentation does not meet performance thresholds, revising and resubmitting the documentation at no cost to the Government is the preferred method for correcting unacceptable performance.

7.3 Performance Objectives, Indicators, Thresholds, and Surveillance Methods. The services required by the contractor are summarized into performance objectives and indicators, along with the minimum standards that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

7.4 Human Trafficking. As with all Government contracting actions the contractor will be screened and the service teams assessed with backgrounds investigated for any records of criminal history and to preclude any possibility of any of the required services being supplied or performed by any individual, group, organization, company, corporation or other foreign Government engaged in human trafficking, smuggling or other crimes against humanity.

PERFORMANCE REQUIREMENTS SUMMARY (PRS)

Performance Objective

Performance Indicator Performance Threshold

Method of Surveillance

PRS # 1. Service document

A. Date and Time of Notification B. Date and Time of Arrival C. Time Spent for Repair D. Description of Malfunction and/or Maintenance Performed E. Description of Parts Replaced

95% accuracy and completeness with first draft.

100% accuracy with one correction/rewrite.

Random inspection of deliverables

Performance Objective

Performance Indicator Performance Threshold

Method of Surveillance

PRS # 2 Final Report/Invoice

Final Report contains required information and is accurate, complete and accepted in accordance with the DID and the Government schedule.

95% accuracy and completeness

100% accuracy and completeness with one correction/rewrite.

100% inspection of deliverables

The evaluation ratings are as follows:

Very Good - Performance meets contractual requirements and exceeds some to the Government’s benefit. The contractual performance of the task and sub-task being assessed was accomplished with some minor problems for which corrective actions taken by the contractor were effective.

Satisfactory - Performance meets contractual requirements. The contractual performance of the task and sub-task contain some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Marginal - Performance does not meet some contractual requirements. The contractual performance of the task and sub-task being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Unsatisfactory – Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the task or sub-task contains a serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

Signature:

Printed Name: Chris McCollum Electronic Signature:

Title: Equipment Specalist Date: 2/20/18

Contracting Officer Representative (COR)

Past Performance Questionnaire This Questionnaire relates to solicitation requirements for

PAST PERFORMANCE QUESTIONNAIRE –

Your assistance is requested in support of a source selection for Anniston Army Depot.

Please complete this Questionnaire and e-mail or send by facsimile [FAX: 256-235-6353 Director of Contracting Anniston Army Depot 7 Frankford Ave.

Anniston, AL 36201-4199

ATTN: Luke Martin Phone: 256-741-5128 E-mail: luke.a.martin18.civ@mail.mil

Desired Response Date:

When complete, the information on this form is SOURCE SELECTION SENSITIVE INFORMATION (41 U.S.C. 423) and shall be protected accordingly.

Proposed prime contractor

1. OFFEROR NAME OFFEROR ADDRESS

Contractor Name and Address and contract/project information being addressed in this questionnaire

2. CONTRACTOR NAME & ADDRESS: 2. CONTRACT NO.:

3. CONTRACT INITIATION DATE:

4. COMPLETION DATE:

5. CONTRACT VALUE (with options):

6. TYPE OF CONTRACT:

7. DESCRIPTION OF PROJECT REQUIREMENTS:

8. Point of Contact: Provide the following information for the company and individual completing this questionnaire:

Company/Agency Name and Address:

Name of person completing this questionnaire:

Title:

Role/responsibility for the effort being addressed in the survey:

Phone Number:

E-Mail:

Rating Scale:

EXCELLENT: Superior performance. Objectives/requirements essentially always achieved or exceeded, with inconsequential exceptions.

GOOD: Highly satisfactory performance. Objectives/requirements achieved with only rare exceptions, and the exceptions had minor consequences.

ADEQUATE: Generally satisfactory performance. Objectives/requirements generally achieved with occasional exceptions, and, in most cases, the exceptions had minor consequences.

MARGINAL: Occasionally unsatisfactory performance of significance.

Objectives/requirements were not fully achieved, with significant consequences in some cases.

POOR: Frequently unsatisfactory performance of significance. Objectives/requirements frequently not achieved, with significant consequences.

UNKNOWN: Unable to rate, not observed, or not a significant aspect of performance.

9. Questionnaire: Please indicate the rating that best reflects your experience with this contractor and provide a short narrative addressing the basis for the ratings assigned. Address compliance with requirements, actual performance, problems encountered and problem resolution. Use additional sheets if necessary. Excellent contract management, attention to Detail and Quality Assurance.

A. Customer Satisfaction – Assess the contractor’s business-like concern for its customers, including such factors as dependability, flexibility, early problem identification, communication, and responsiveness.

B. Schedule – Assess the contractor’s adherence to delivery commitments; responsiveness to requests for accelerations; and early identification and mitigation of schedule slippages.

C. Technical Requirements – Assess the contractor’s performance in conforming to contract specifications:

D. Technical Responsiveness – Assess the contractor’s ability to identify and resolve technical problems effectively and in a timely manner, including correction of faulty work and warranty claims:

Excellent Good Adequate Marginal Poor Unknown

E. Overall Assessment: Provide your overall assessment.