Exhibit A Past Performance Relevancy Questionnaire.doc

EXHIBIT A PAST PERFORMANCE RELEVANCY QUESTIONNAIRE

PART 1: Prepare the following information (3) to five (5) times.

Provide the following information requested in this format for each of the three to five projects/contracts being described. Projects may be on-going and cannot have been completed any earlier than 5 years from the solicitation issue date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you identify. Use as much space as required.

A. Offeror (Your) Name (Company/Division): _______________________________________

B. Project/Contract Title: ________________________________________________________

C. Contract Specifics:

1. Description of Effort as ___________ Prime or _________ Subcontractor

2. Contract Number: __________________________________________

3. Original Contract Value: $______________________

4. Current/Final Contract Value: $______________________

5. If amounts above are different, provide a brief description of the reason:

6. Completion Date:

a. Original Date: __________________________

b. Current Schedule:_________________________

c. Establish/Final Completion Date: _____________________________

d. Primary cause for Contract Modification: _________________________________________

D. On a separate page, provide a detailed description of the work performed under the contract, to include but not limited to hospital renovations. Describe the similarity of the construction methods, size, project scope, cost magnitude and complexity of work performed to those required for the proposed effort. Also discuss similarity of the client type and/or location at which work was performed to the location(s) at which work will be performed and the key personnel of the referenced project to the performance under the proposed contract.

VA Saginaw Electrical Closets RFP W911XK-10-R-0006

In addition, address the following:

Describe the specific elements of the work performed.

Indicate what elements of work were performed by your major subcontractors and if those same subcontractors and if those same subcontractors will be used on this project. If you intend to use these subcontractors, please list their name (s) and principle areas of work they will perform.

Address any technical areas about the project you consider uniquely relevant to this project.

If you intend to use any of the same key personnel on this solicitations’ project, indicate by name and position those personnel occupied on the reference contract. ( Project Manager, Site Superintendent, Quality Control Manager). Indicate what position they will have on this solicitation’s contract.

Describe why you believe the work is “Very Relevant”, “Relevant” or “Semi-Relevant” to this solicited project. (See Section 00120 of the RFP for a description of these terms. Use as much space as necessary.

E. List Points of Contact for the Owner/Government agency Contracting Officer and or inspector; include a current phone number and facsimile number. An e-mail address is also desired. (Even though you will be sending Exhibit C letters and questionnaires to these references, do not include a copy of the Exhibit Cs in your proposal.)

End of Part 1 - Questionnaire Requirements – Prepare and send Exhibit C Package to the reference(s) for each of these projects.

VA Saginaw Electrical Closets RFP W911XK-10-R-0006

EXHIBIT A PAST PERFORMANCE RELEVANCY QUESTIONNAIRE

PART 2: Provide the following information one time.

Additional Offeror information required, but not project specific. This information need only be provided once in your submission package.

2A. Applicable to all Offerors - Describe your Compliance with the requirements of FAR clause 52.219-8, Utilization of Small Business Concerns (Oct 2000). (Even if you are a Small or Small Disadvantaged Business, this clause in Federal Contracts applies.)

It is the policy of the United States that small business concerns, veteran-owned small business concerns, service-disabled veteran-owned small business concerns, HUBZone small business concerns, small disadvantaged business concerns, and women-owned small business concerns shall have the maximum practicable opportunity to participate in performing contracts let by any Federal agency, including contracts and subcontracts for subsystems, assemblies, components, and related services for major systems. It is also policy to establish procedures to ensure the timely payment of amounts due pursuant to the terms of their subcontracts (FAR Clause 52-2198). Describe below the methods you have used to comply with this policy on prior federal contracts. Include any evidence, or a point of contact to verify this information, if available.

2B. Unless previously discussed, provide the names of the following Key Personnel to be used on this project: Project Manager, Site Superintendent, and Quality Control Manager.

In the event the intended key personnel for this construction do not have demonstrated past performance in the project(s) submitted in Exhibit A, additional information is required. Each key personnel without prior past performance history submitted shall complete an Exhibit B, “Subcontractor/Team/Key Personnel Information and Consent Form”. The Government may seek additional references and reserves the right to use the information provided to obtain additional references.

2C. Describe the circumstances of any assessment of liquidated damages on any contracts within the last five years (frequency, severity of problem, etc.).

2D. Offerors are strongly encouraged to include with their proposals information on problems encountered on relative projects and the specific corrective actions taken to remedy the problems.

2E. Other Past Performance Considerations (OPTIONAL) Information, if provided, shall be limited to the period starting 5 years prior to the solicitation release date.

Effectiveness of value engineering (VEC) proposals you submitted on prior contracts. (Provide a brief description; impact on cost, schedule, efficiency or quality; contract number; name and phone number of customer benefiting from the VEC). Professional/Industry awards (Identify award type, date of award and copy of certificate if applicable), Letters of appreciation, recognition or commendations. Discuss unique skills and accomplishments (Explain unique skills and/or accomplishments and provide supporting information for verification).