Exhibit C Past Performance Reference Questionnaire 9 November 2011.doc

FY11 Great Lakes Dredging MATOC

RFP W911XK-11-R-0018

EXHIBIT C - Past Performance Reference Questionnaire

Instructions to Offeror for sending Reference Questionnaire Forms:

Prepare and submit this package to the owners of the projects listed in your Exhibit A “Performance Relevancy Questionnaires”. For Government contracts, send to the Contracting Officer or Technical Representative. For commercial references, send to personnel with duties similar to those for Government contracts. Offerors should follow-up and encourage references to get the questionnaires to the Contracting Office in a timely manner. If you have multiple references at one location (military installation, building, etc.), send one cover letter and questionnaire for each contract you want a reference for. Your questionnaire package should contain the following:

· Cover Letter (See the Sample on the following page).

· Past Performance Questionnaire (the next 5 pages). The Offeror should put its name in the spaces indicated and ensure it is on every page for identification purposes.

· Suggested – Addressed and stamped envelope to return to Contracting Officer.

THE OFFEROR SHOULD PLACE THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE.

THE OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES.

SAMPLE TRANSMITTAL LETTER AND

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Your Company Letterhead

Date:

To:

We have listed your {{firm or agency}} as a reference for the work we have performed for you as identified on the following page. Our firm has submitted a proposal under a project advertised by the Detroit District US Army Corps of Engineers Contracting Office. In accordance with Federal Acquisition Regulations (FAR), they will evaluate our firm's past performance. Your candid response to the attached questionnaire will assist the evaluation team in this process.

We understand that you have a busy schedule and your participation in this evaluation is greatly appreciated. Please complete the enclosed questionnaire as thoroughly as possible. Space is provided for comments. Understand that while the responses to this questionnaire may be released to the Offeror, FAR 15.306 (e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained. Only one response from each office is required.

E-mail is the preferred form of response for this evaluation. Please submit completed questionnaires in PDF format to LRE-Quotes@usace.army.mil, no later than {{DUE DATE FOR PROPOSALS}}. Questionnaires may also be faxed to (313) 226-2209, Attn: Ashley Kuwik, or mailed to the following address:

USACE Detroit District

Contracting Office Attn: Ashley Kuwik 477 Michigan Ave., Room 700

Detroit, MI 48226-4523 If you have questions regarding the attached questionnaire or require assistance, please contact Ashley Kuwik at (313) 226-6421. Thank you for your assistance.

Signature and Title

NAVFAC/USACE PAST PERFORMANCE QUESTIONNAIRE (Form PPQ-0)

CONTRACT INFORMATION (Contractor to complete Blocks 1-4)

1. Contractor Information Firm Name:

CAGE Code:

Address:

DUNs Number:

Phone Number:

Email Address:

Point of Contact: Contact Phone Number:

2. Work Performed as: FORMCHECKBOX Prime Contractor FORMCHECKBOX Sub Contractor FORMCHECKBOX Joint Venture FORMCHECKBOX Other (Explain)

Percent of project work performed:

If subcontractor, who was the prime (Name/Phone #):

3. Contract Information Contract Number:

Delivery/Task Order Number (if applicable):

Contract Type: FORMCHECKBOX Firm Fixed Price FORMCHECKBOX Cost Reimbursement FORMCHECKBOX Other (Please specify):

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 FORMCHECKBOX High FORMCHECKBOX Med FORMCHECKBOX 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: USACE REQUESTS THAT THE CLIENT COMPLETES THIS QUESTIONNAIRE AND SUBMITS DIRECTLY TO USACE. QUESTIONNAIRES THAT ARE SUBMITTED DIRECTLY FROM THE OFFEROR WILL NOT BE ACCEPTED.

ADJECTIVE RATINGS AND DEFINITIONS TO BE USED TO BEST REFLECT

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

RATING

DEFINITION

NOTE

TO BE COMPLETED BY CLIENT

PLEASE CIRCLE THE ADJECTIVE RATING WHICH BEST REFLECTS

YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE.

1. QUALITY:

2. SCHEDULE/TIMELINESS OF PERFORMANCE:

3. CUSTOMER SATISFACTION:

4. MANAGEMENT/ PERSONNEL/LABOR

5. COST/FINANCIAL MANAGEMENT

6. SAFETY/SECURITY

7. GENERAL

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):

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