Appendicies I-XII.pdf

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Attached to
Conemaugh River Lake Building and Grounds Maintenance Services
Solicitation number
W911WN24Q3008
Issued by

About this file

This document provides details for a federal contract solicitation for building and grounds maintenance services. The U.S. Army Corps of Engineers, Pittsburgh District has requirements for maintenance services at Conemaugh River Lake, including grounds maintenance, cleaning services, solid waste removal, and raw sewage and sludge removal. The NAICS code is 561730 for landscaping services and the small business size standard is $9.5 million. The period of performance is 1 May 2024 to 30 April 2025 with four optional one-year extensions, not to exceed a total of 5 years and 6 months. The solicitation will be released on or around 12 January 2024 via PIEE-SOL and posted to SAM.gov. A pre-quote meeting and site visit is scheduled for 17 January 2024 with an alternate date of 24 January 2024 at Loyalhanna Lake and Conemaugh River Lake to review requirements. This procurement is set aside 100% for small businesses. Offerors must be registered in SAM.gov with active representations and certifications completed prior to award.

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File Type Posted
Attachment 8 - Price Schedule W911WN24Q3008 0002.xlsx XLSX spreadsheet
W911WN24Q3008 0002.pdf PDF
W911WN24Q3008 0001.pdf PDF
Attachments 1-7 W911WN24Q3008 0001.pdf PDF
W911WN24Q3008.pdf PDF
Attachment 8 - Price Schedule.xlsx XLSX spreadsheet
Addendum to 51.212-1.pdf PDF
Attachments 1-7.pdf PDF

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I Vendor Registration

Intro

Appendix I

Procurement Integrated Enterprise Environment (PIEE) Vendor Registration

Welcome to Procurement Integrated Enterprise Environment (PIEE). This demonstration contains audio narrative. Please adjust your volume accordingly.

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This is an overview of the registration process for Vendor users in PIEE. Please note that all data entered in this demo do not reflect actual user requirements and are for purposes of example only.

Built with Tanida Demo Builder www.demo-builder.com

Vendor Registration

Ste 2

Appendix I

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Ser·••• ;n, a Vendor or COnuxior with tMIMl''sCAGf code(s)

Vendors will need to take the following steps to establish an account in PIEE:

Complete Vendor activation requirements specified in the Vendors Getting Started section of the Help/Training page.

Self-register as a Vendor or Contractor with the user's CAGE code(s).

Ste 3

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Review the Privacy Statement and Warning messages and select the Accept button.

Ste 4

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Appendix I

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To begin the Vendor registration process, select the Start the registration process link.

Ste 5

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Select the Agree button to accept the Privacy Act Statement.

Ste 6

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Select Vendor from the role type list.

Ste 7

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Appendix I

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Select the appropriate authentication type from the dropdown list. For training purposes, this presentation demonstrates the use of user ID and password authentication.

Ste 10

Appendix I

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Complete all required fields on the User Profile page. PLEASE NOTE: The data presented in the following demonstrations (CAGE Code, DoDAAC, user profile information, etc.) are for purposes of example only. All users must utilize their own personal information.

Ste 11

Upon completion of the User Profile information, the user may save the registration by selecting the Save Registration button.

The user will have 30 days to complete the registration upon saving.

Ste 12

Appendix I v .. ____ .,.,_ .. _____ _

Upon selecting the Save Registration button, the user may select Continue Registration or Exit Registration And Finish Later.

Ste 13

Select the Next button to continue.

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Ste 14

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Appendix I

Complete all required fields on the Additional Profile Information page. Select the Next button to continue.

Ste 15

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The Roles page is displayed. Expand the Application dropdown menu in Step 1 to view all applications available to Vendors within PIEE.

Ste 16

Select the desired application from the dropdown menu.

Ste 17

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Appendix I

Upon selection of the desired application, a list of available roles will be displayed in Step 2. Select the appropriate role and select the Add Roles button.

Ste 18

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The selected role is displayed in the Roles Summary section. Enter the appropriate CAGE code in the Location Code field. If it is unknown which CAGE should be used, users should contact their Contractor Administrator (CAM).

Ste 19

If the CAGE code has an extension, enter it in the Extension field.

Ste 20

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Multiple Vendor roles may be added simultaneously. To add another role, select the desired application and role in Steps 1 and

2. Select the Add Roles button.

Ste 21

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If the user adds a role for which additional information is required, an info message will direct the user to the Group Lookup tool. Select Group Lookup from the Action column for the role requiring additional information.

Ste 22

Appendix I

The user may search the directory using Group Name or Location. Expand the Search dropdown and select the desired option.

Enter the search criteria in the Group Search field and select the Search button.

Ste 23

The search criteria will return a list of matching groups. Select the appropriate group from the Group Name list.

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The group name is displayed in the Group column. When finished adding roles, select the Next button to continue.

Ste 25

Enter appropriate data in the Justification field. Attachments are optional. Select the Next button to continue.

Appendix II

Electronic Invoicing Instructions for the USACE Finance Center

In lieu of submitting a hardcopy invoice to the USA CE Finance Center (UFC) in Millington, TN via the United States Postal Service per the contract instructions in Block 18a, you may submit an electronic version via email per the instructions below:

1. Save or scan the invoice so that it is an electronic (pdf) file.

2. Circle the amount to be paid. See Attached Example.

3. File name of the INVOICE must be the obligation number. (ex: W911 WN-00-X-0000).

4. Attach the Invoice (see# 3) to an email. Make sure the file name is the obligation number.

5. The subject line of the email should contain only the OBLIGATION number (same as the INVOICE file name)

6. Email the PDF file to: CEFC-H4 Invoices@usace.army.mil and CC your contracting POC as well as the USACE project POC to whom the goods or services were delivered to confirm receipt.

7. You can only submit ! invoice per email to the UFC. If you need to submit 3 invoices then you must send 3 separate emails.

8. See below for a sample email submission to the UFC.

9. This process does not apply to ENG93 payments; i.e. Progress payments for construction and Architect/Engineer contracts.

BILL TO

U S _"'u:,ny Corps ofE.ogineers Acc:ounis Pay:ible Ftnanc.e Cenrer 5722 Integrity Drive Millington.. TN 38054-50<)5

SITE-OJ\.iR.

SOL-UPG-R-C::

RTU-C-VZ

TERMS REP

_ �et 30

Sen.-ic:es @S2.910.00 eriz.on �ular data service allowance_ priced per year On-site servic:e for deplo removal of exSens sy Parts @ $2_ 790.00 Upgrade of an SOL SDL500C cellul labor Cellular

SHIP TO

US Anny Corps of Engineers Water Quality Field Office Carl im

3500 Grand Avenue Pinsburgh, P'eni:isvi.r'ania

Total

1.095.00

1.295.00

1.495.00

720.00

2.190.00

1.295.00

1.495.00

Appendix II

Mon 8119/2019 2:53 PM

Walters, Patricia A CIV USARMY CELRP (US)

W911WN-16-C-3001

o CEFC-H4 InvOtCes c Falvo, Anthony J CIV USARMY Ca.RP (USA)

Message � W911WN-16-C-3001.pdf (98 KB)

Good Afternoon, Please process for payment.

Thanks, Patricia A. Walters

Accountant

Resource Management Division

US Army Corps of Engineers, Pittsburgh Distri

Office: {412) 395-7481

Patricia.a. walters@usace .army .mil

Items to Note:

1. Circle the dollar amount to be paid on the invoice

2. If you are sending multiple invoices to the Finance Center, each invoice must be sent down in a separate email. Only 1 invoice per email.

3. The attached invoice's file name must be the obligation number.

4. The subject of the email to the UFC must also be the obligation number.

5. Email is sent to CEFC-H4 Invoices@usace.army.mil AND

6. CC the USACE contracting POC and the USACE Project POC to whom the goods or services were provided.

7. This new process does not apply to ENG93 payments; i.e. Progress payments for construction and Architect/Engineer contracts.

Appendix III

(Put on Company Letterhead)

QUALITY CONTROL PLAN

W911WN-24-D-3:XXX

Building and Grounds Maintenance Services

Conemaugh River Lake Saltsburg, Pennsylvania

Brief statement describing your company's management philosophy relative to its commitment to quality.

I. Describe inspection process for each section of the contract.

2. List names of inspectors.

3. Describe process to identify deficiencies in quality of services performed before the level of performance is unacceptable.

4. Describe process for retaining records of inspections and corrective actions taken.

5. Accident Prevention:

COR

a. Policy Statement for accident prevention signed by the Contractor (program and enforcement)

b. Emergency phone numbers

c. Equipment inspections

d. Safety training

e. Personal protective equipment required

Signature of contractor

Approved by:

Date:

Date:

Appendix IV Contract Overview Workbook

Appendix V

1. SIGNATURE SHEET.

ACCIDENT PREVENTION PLAN

Building and Grounds Maintenance Services

Conemaugh River Lake

Contract Number Contractor Name

This Accident Prevention Plan was

Prepared By:

Name

Title of corporate safety staff person

Approved By:

Name

President

2. BACKGROUND INFORMATION

a. Contractor: Name

Address

City, State Zip

b. Contract Number W911 WN-24-D-3###

c. Project Name: Loyalhanna Lake

d. Project Description: Building and Grounds Maintenance Service

e. Name of Company's recent accident history is included as Attachment #_to this Accident

Prevention Plan. Information included includes EMR, OSHA 200 Forms and corporate safety trend analyses.

f. The Major definable features of work are: _____________ . An Activity

Hazard Analysis (AHA) will be prepared for each Major Definable Feature of Work. AHAs

Appendix VII

CUI

Contract Location: Company P0C Name:

Contract Number: Army C0R Name:

Please do not send multiple 1-2 person requests in a single day

NAME (Last, First Middle) DOB (mm/dd/yyyy) SSN (no dashes)

CUI

Controlled by: USAGE

Controlled by: CELRP-SM

Category: PRVCY

Distribution: FED ONLY

POC: See below

CUI

Primary Contact: Ivan Russell - Security Specialist

412-39S-7S91 ivan.r.russell@usace.army.mil

Alternate Contact: Andrew Wasko - Security Specialist

412-39S-7643 andrew.j.wasko@usace.army.mil

Chief of Security: Joe Bali

412-395-7162 joseph.m.bali@usace.army.mil

CUI

Appendix IX Actual Services Performed

Base Year Actual Services Performed

Hours for one employee to

Description Of Service JAN FEB MAR APR MAY JUN JULY AUG SEP OCT NOV DEC TOTAL(EST) perform a single service

Appendix X

ANNUAL PEST CONTROL PLAN

FOR CALENDAR YEAR __ _

ANTICIPATED USAGE REPORT _ACTUAL USAGE REPORT _DATE OF REPORT: ___ _

FIELD OFFICE: _____________ DISTRICT: __ ___._P

ITT

S=B

U=R=G=H

APPLICATION INFORMATION:

APPLICATE ACCOMPLISHMENT: IN-HOUSE _CONTRACT _NEGATIVE REPORT

NAME OF APPLICATOR/CONTRACTOR: __________________ _

APPLICATOR LICENSE NO. _________ _

PESTICIDE INFORMATION:

*PESTICIDE TRADE NAME: ___________ EPA REG. NO. _______ _

EPA CLASS: GENERAL-USE PESTICIDE__ RESTRICTED-USE PESTICIDE __ _

% ACTIVE INGREDIENT: _______________________ _

DILUTENT: ________ MIXING RATE: ________ _

APPLICATION RATE: METHOD OF APPLICATION: __________ _

NO. OF APPLICATIONS ___ ACTIVITY HAZARD ANALYSIS WILL BE CONDUCTED: __ _

SITE INFORMATION:

DESCRIPTION OF TREATMENT SITE (S):

TOTAL ESTIMATED ACREAGE TREATED: ___ QUANTITY OF PESTICIDE USED: ___ _

TARGET PEST (S): ________________________ _

PLAN SUBMITTED BY: _________ PLAN APPROVED BY: ______ _

• Pesticides include fungicides, herbicides, insecticides, larvicides and rodenticides (See ER 1130-2-540, dated 15 November 96).

Appendix XI

PESTICIDE APPLICATION RECORD 11. START DATE (YYYYMMDD)

2 INSTALLATION

3 SITE TREATED

4. PEST TREATED

5. PURPOSE

SECTION I - CONDITIONS DURING TREATMENT

1. AIR TEMPERATURE (Fahrenheit Deareesl 12. WATER TEMPERATURE (Fahrenheit De grees if applicable)

3. OVERCAST (Percen tage %) 14. WIND DIRECTION (N, NE, E, SE, S, SW, WorNvJ,1 15. WIND VELOCITY (mph)

1. COMMON NAME

2 ACTIVE INGREDIENT AND PERCENTAGE%

3. MANUFACTURER

5. REGISTRERED USE

C,,LU"CC:TC

SECTION II - PESTICIDE RECORD

14. REGISTRATION NUMBER

AVAILABLE 0 YES ONO

6. MATERIAL SAFETY DATA (MSDS) □ BREATHING APPARATUS

n11□11\1� .o.cc1 11"'11.Tlf"II\I f"I ••Ac-v

7. PERSONAL PROTECTION EQUIPMENT DEVICE WORN (Dust Unfiltered)

0 MASK (Filtered) Q EYEWEAR Q GLOVES O BOOTS 0 HOOD Q PROTECTIVE SUIT 0 TREATED AREA ENCLOSED

Q TREATED AREA OPEN (Ventilated) Q NONE REQUIRED OR WORN PER MSDS DATA Q OTHER SAFETY REQUIREMENTS

8. MIXTURE OR FORM APPLIED (e. g., 20 to 1, Spray, paste, poured, fumigation or Solid)

9. APPLICATION RATE 110. APPLICATION METHOD

11. SPECIAL PRECAUTIONS TAKEN (if none so state)

1? NI JMRl=A f"II= - ''IIFI I 1ci::n IN II.COi 11'"'1\. Tlf"II\I //fof nfhor ~~ • in rorn<>rlrc, ho/nwl

13. OTHER EQUIPMENT USED NOT PREVIOUSLY LISTED

14.A C C U M U L A T I V E T R E A T M E N T�dfts'i:m�, ti a 15. CXXFERl\llt--G JIG3'.tES give n are a dur in g t h e Of8Mn d ar

a. UNITS TREATED b. QUANTITY USED

(1) PREVIOUS (1) PREVIOUS

(2) PRESENT (2) PRESENT

(3) TOTAL (3)TOTAL

16. REMARKS

SECTION 111- CERTIFIED APPLICATOR'S Sl�ATURE CERTIFICATION

I HEREBY CERTIFY THAT THIS INFORMATION IS A TRUE AND CORRECT RECORD OF THE PESTICIDE APPLICATION.

1. OTHER DOCUMENTATION ATTACHED 2a. DATE (YYYYMMDD) b. SIGNATURE (Certified Applicator)

0 YES 0 NO

CELRI FORM 1031, APR 2010 PREVIOUS EDITIONS ARE OBSOLETE. VERSION 11

Form PPQ -0 (9/30/11)

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0) CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

CAGE Code: ______________ DUNs Number: _______________________

1. Contractor Information Firm Name: _______________________________________________ Address: ________________________________________________ Phone Number: __________________________________________ Email Address: ____________________________________________ Point of Contact: ___________________________________________ Contact Phone Number: ______________

Sub Contractor Joint Venture Other (Explain)2. Work Performed as: Prime Contractor Percent of project work performed: _________ If subcontractor, who was the prime (Name/Phone #): ___________________________________________________

Cost Reimbursement Other (Please specify):

3. Contract Information Contract Number: ____________________________________ Delivery/Task Order Number (if applicable): ________________________________________ Contract Type: Firm Fixed Price ____________________ Contract Title: ______________________________________________________________________ Contract Location: __________________________________________________________________

Award Date (mm/dd/yy): ________________________ Contract Completion Date (mm/dd/yy): _________________ Actual Completion Date (mm/dd/yy): ___________________ Explain Differences: _______________________________________________________________________________

Original Contract Price (Award Amount): _________________ Final Contract Price (to include all modifications, if applicable): ___________________ Explain Differences: _______________________________________________________________________________

4. Project Description:

Complexity of Work High Med Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.) __________________________________________________________________________________

CLIENT INFORMATION (Client to complete Blocks 5-8)

5. Client Information Name: _________________________________________ Title: __________________________________________ Phone Number: _________________________________ Email Address: ______________________________________________

6. Describe the client’s role in the project: ___________________________________________________________

7. Date Questionnaire was completed (mm/dd/yy): _____________________

8. Client’s Signature: ______________________________________________

NOTE: NAVFAC/USACE requests that the client completes this questionnaire and submits directly back to the offeror.

The offeror will submit the completed questionnaire to USACE with their proposal, and may duplicate this questionnaire for future submission on USACE solicitations. Clients are highly encouraged to submit questionnaires directly to the offeror. However, questionnaires may be submitted directly to USACE. Please contact the offeror for USACE POC information. The Government reserves the right to verify any and all information on this form.

Appendix XII NAVFAC / USACE Past Performance Questionnaire (PPQ)

NAVFAC / USACE Past Performance Questionnaire (PPQ) Form PPQ -0 (9/30/11)

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING DEFINITION NOTE

(E) Exceptional Performance meets contractual requirements and exceeds many to the Government/Owner’s benefit.

The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

An Exceptional rating is appropriate when the Contractor successfully performed multiple significant events that were of benefit to the Government/Owner. A singular benefit, however, could be of such magnitude that it alone constitutes an Exceptional rating. Also, there should have been NO significant weaknesses identified.

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

A Very Good rating is appropriate when the Contractor successfully performed a significant event that was a benefit to the Government/Owner. There should have been no significant weaknesses identified.

(S) Satisfactory Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

A Satisfactory rating is appropriate when there were only minor problems, or major problems that the contractor recovered from without impact to the contract. There should have been NO significant weaknesses identified. Per DOD policy, a fundamental principle of assigning ratings is that contractors will not be assessed a rating lower than Satisfactory solely for not performing beyond the requirements of the contract.

(M) Marginal Performance does not meet some contractual requirements. The contractual performance of the element or sub-element 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.

A Marginal is appropriate when a significant event occurred that the contractor had trouble overcoming which impacted the Government/Owner.

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

An Unsatisfactory rating is appropriate when multiple significant events occurred that the contractor had trouble overcoming and which impacted the Government/Owner. A singular problem, however, could be of such serious magnitude that it alone constitutes an unsatisfactory rating.

(N) Not Applicable No information or did not apply to your contract Rating will be neither positive nor negative.

TO BE COMPLETED BY CLIENT

PLEASE SELECT THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY

a) Quality of technical data/report preparation efforts E VG S M U N

b) Ability to meet quality standards specified for technical performance E VG S M U N

c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance E VG S M U N

d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance)

E VG S M U N

2. SCHEDULE/TIMELINESS OF PERFORMANCE

a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below)

E VG S M U N

b) Rate the contractor’s use of available resources to accomplish tasks identified in the contract E VG S M U N

3. CUSTOMER SATISFACTION

a) To what extent were the end users satisfied with the project? E VG S M U N

b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes;

responsiveness to administrative reports, businesslike and communication)

E VG S M U N

c) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer? E VG S M U N

d) Overall customer satisfaction E VG S M U N

4. MANAGEMENT/ PERSONNEL/LABOR

a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force? E VG S M U N

b) Ability to hire, apply, and retain a qualified workforce to this effort E VG S M U N

c) Government Property Control E VG S M U N

d) Knowledge/expertise demonstrated by contractor personnel E VG S M U N

e) Utilization of Small Business concerns E VG S M U N

f) Ability to simultaneously manage multiple projects with multiple disciplines E VG S M U N

g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes E VG S M U N

h) Effectiveness of overall management (including ability to effectively lead, manage and control the program) E VG S M U N

5. COST/FINANCIAL MANAGEMENT

a) Ability to meet the terms and conditions within the contractually agreed price(s)? E VG S M U N

b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client

E VG S M U N

c) If this is/was a Government cost type contract, please rate the Contractor’s timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns)

E VG S M U N

d) Is the Contractor’s accounting system adequate for management and tracking of costs? If no, please explain in Remarks section. Yes No

e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below.

Yes No

f) Have there been any indications that the contractor has had any financial problems? If yes, please explain below. Yes No

6. SAFETY/SECURITY

a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues?

(Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.)

E VG S M U N

b) Contractor complied with all security requirements for the project and personnel security requirements. E VG S M U N

7. GENERAL

a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues).

E VG S M U N

b) Compliance with contractual terms/provisions (explain if specific issues) E VG S M U N

c) Would you hire or work with this firm again? (If no, please explain below) Yes No

d) In summary, provide an overall rating for the work performed by this contractor. E VG S M U N

Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):

Appendices I-XII
Appendix I
Appendix II
Appendix III
Appendix IV
Appendix V
Appendix VI
Appendix VII
Appendix VIII
Appendix IX
Appendix X
Appendix XI
Appendix XII Past Performance Questionnaire
CONTRACT INFORMATION Contractor to complete Blocks 14:
CAGE Code:
Firm Name:
DUNs Number:
Address:
Phone Number:
Email Address:
Point of Contact:
Contact Phone Number:
Prime Contractor: Off
Sub Contractor: Off
Joint Venture: Off
Other Explain: Off
Percent of project work performed:
If subcontractor who was the prime NamePhone:
Contract Number:
DeliveryTask Order Number if applicable:
Firm Fixed Price: Off
Cost Reimbursement: Off
undefined: Off
Other Please specify:
Contract Title:
Contract Location:
Award Date mmddyy:
Contract Completion Date mmddyy:
Actual Completion Date mmddyy:
Explain Differences:
Original Contract Price Award Amount:
Final Contract Price to include all modifications if applicable:
Explain Differences_2:
High: Off
Med: Off
Routine: Off
conditions etc 1:
conditions etc 2:
conditions etc 3:
CLIENT INFORMATION Client to complete Blocks 58:
5 Client Information Name Title Phone Number Email Address:
Name:
Title:
Phone Number_2:
Email Address 1:
Email Address 2:
6 Describe the clients role in the project 1:
6 Describe the clients role in the project 2:
undefined_2:
7 Date Questionnaire was completed mmddyy:
undefined_3:
8 Clients Signature:
A: Choice10
B: Choice16
PPQ: Choice16
C: Off
D: Off
E: Off
F: Off
G: Off
H: Off
I: Off
J: Off
K: Off
L: Off
M: Off
N: Off
O: Off
P: Off
Q: Off
R: Off
which may assist our office in evaluating performance risk please attach additional pages if necessary 1:
which may assist our office in evaluating performance risk please attach additional pages if necessary 2:
which may assist our office in evaluating performance risk please attach additional pages if necessary 3:
which may assist our office in evaluating performance risk please attach additional pages if necessary 4:
which may assist our office in evaluating performance risk please attach additional pages if necessary 5:
which may assist our office in evaluating performance risk please attach additional pages if necessary 6:
which may assist our office in evaluating performance risk please attach additional pages if necessary 7:
which may assist our office in evaluating performance risk please attach additional pages if necessary 8:
which may assist our office in evaluating performance risk please attach additional pages if necessary 9:
which may assist our office in evaluating performance risk please attach additional pages if necessary 10:
which may assist our office in evaluating performance risk please attach additional pages if necessary 11:
S: Off
T: Off
U: Off
V: Off
W: Off
X: Off
Y: Off
Z: Off
AA: Off
AB: Off
AC: Off

File details come from the government source that posted it. Updated .