W9126G17Q0016_(Conformed_Copy).pdf

SEE ADDENDUM

(No Collect Calls)

W9126G17Q0016 18-Aug-2017

b. TELEPHONE NUMBER

817 886-1080

8. OFFER DUE DATE/LOCAL TIME

02:00 PM 08 Sep 2017

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA X ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W9126G9. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

JASON S RINEHART

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

1 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.X

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

US ARMY ENGINEER DISTRICT, FORT WORTH

ATTN: CESWF-CT

819 TAYLOR ST, ROOM 2A17

FORT WORTH TX 76102-0300

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

FORT WORTH FEDERAL CENTER WAREHOUSE NO.

LOREE BALDI

501 W. FELIX STREET

FORT WORTH TX 76115

TEL: (817) 8865-1808 FAX:

817-886-6403FAX:

TEL: 817-886-1043 SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

1,000

NAICS:

336211

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF70

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

W9126G17Q0016

Section SF 1449 - CONTINUATION SHEET

INSTRUCTIONS TO OFFERORS

INSTRUCTIONS TO OFFEROR

QUOTER DUE DATE/LOCAL TIME: see block 8, SF 1449 Central Standard Time (CST) POINT OF CONTACT: Scott Rinehart Phone: 817-886-1080 Email POC: jason.s.rinehart@usace.army.mil

Quotes shall be accepted via “EMAIL ONLY,” no fax, mail, express mail, or hands carry, “NO EXCEPTIONS.” EMAIL your proposal to: CIV-OPS.Proposals@usace.army.mil cc:

jason.s.rinehart@usace.army.mil Subject line of email: Include the solicitation number and your name

For additional help contact your local Procurement Technical Assistance Centers (PTAC).

Centers were created by Congress to assist businesses seeking to compete on federal contracts.

Services are generally free; however, a small fee may be charged for certain services. Please use website http://www.aptac-us.org/new/ to contact a center to assist you in the preparation for a federal contract, registering in SAM or other required systems.

SYSTEM FOR AWARD MANAGEMENT (SAM) is REQUIRED to receive an award on all federal government contracts. Therefore, contractors are encouraged to begin this process sooner rather than later. If already registered, please ensure your registration is ACTIVE. The website to register with SAM is: www.sam.gov.

DATA UNIVERSAL NUMBERING SYSTEM (DUNS) is REQUIRED. Dun & Bradstreet (D&B) provides a DUNS Number, a unique nine digit identification number, for each physical location of your business.

DUNS Number assignment is FREE for all businesses required to register with the US Federal government for contracts or grants in the System for Award Management (SAM see below).

The website to obtain your DUNS number: http://fedgov.dnb.com/webform for technical difficulties, contact govt@dnb.com

ONLINE REPRESENTATIONS AND CERTIFICATIONS APPLICATIONS (ORCA)

allows contractors to complete a one-time certification and representations for your use on any solicitation. The website to complete ORCA is available at the System for Award Manager (SAM): www.sam.gov. The information previously maintained in CCR, FedReg and ORCA now is contained within the Entity Management area in SAM. Legacy EPLS information resides in the Performance Information area of SAM. Contractors MUST be certified in the NAICS Code and Size Standard applicable with this solicitation.

ATTENTION TO OFFEROR(s)/CONTRACTOR(s): On July 14, 2014, Small Business Administration (SBA) increased the monetary-based industry size standards to account for inflation. You must update your Representations (Reps) and Certifications (Certs) for the impacted North American Industry Classification System (NAICS) codes identified with an exclamation point "!" next to the "Small Business" value in the System for Award Management (SAM). Please log into SAM, review, and resubmit your registration to apply the new size standard.

Below is a checklist to assist you to ensure all the proper documents are returned for consideration on this solicitation. Only those items checked below as “required” must be returned

Required Contractor Item

Complete page 1 of Solicitation (SF 1449-Sign and date in block 30).

Complete Bid Schedule

Complete Contractor Information Sheet below: Include your SSN or firm’s Tax ID Number (TIN) and active email address.

You may be notified of your selection by this method!!!

Offerors shall complete ORCA profile on line in SAMS:

Clause 52.212-3, paragraph (b) of solicitation OR submit complete

ORCA profile in SAM.

Offerors shall submit an active SAM registration (Attach first page).

The System for Award Management (SAM) is the Official U.S. Government system that consolidated the capabilities of CCR/FedReg, ORCA and EPLS. Website: www.sam.gov

Ensure NAICS Code 336211 is in your Representations and Certification in

SAMS.

EMAIL Past Performance Questionnaire to a former employer or person who can vouch for your work capability or volunteer work.

Ensure former employer return the form and references the solicitation number in the email subject line. CIV-OPS.Proposals@usace.army.mil and cc:

jason.s.rinehart@usace.army.mil

Scan all documents into a single.pdf file. (For Help contact your local Library, copy centers or PTACs-http://www.aptac-us.org/new/

EMAIL your proposal to: CIV-OPS.Proposals@usace.army.mil cc:

jason.s.rinehart@usace.army.mil Subject line of email: Include the solicitation number and your name

Contractor Information Sheet

**THIS MUST BE COMPLETED AND RETURNED WITH YOUR QUOTE**

IN THE EVENT OF AWARD, ISSUE CONTRACT TO:

NAME

(Business Name or Last, First Middle)

ADDRESS

(Number & Street) (City, State and Zip)

PHONE NUMBER

(Area code and number)

EMAIL ADDRESS________________________________________________________________

DUNS NUMBER CAGE CODE NUMBER

SSN/TIN NUMBER ______________________________

SCOPE

WATER TRUCK

SCOPE OF WORK

1. INTRODUCTION: Provide one (1) new water truck to include a newly manufactured truck chassis and built and mounted support body meeting the requirements outlined below. All components for the truck and support body shall be new (i.e. unused and not refurbished) and any parts that require paint shall be white. The contractor shall provide all components described herein, including the truck chassis, and all materials and labor to build and mount the support body; the support body shall include a water tank, crane, tool boxes, and diesel fuel tank to the truck chassis. Specific requirements for the truck chassis and support body are provided below.

Veterans Employment Emphasis for U.S. Army Corps of Engineers Contracts In addition to complying with the requirements outlined in FAR Part 22.13, FAR Provision 52.222-38, FAR Clause 52.222-35, FAR Clause 52.222-37, DFARS 222.13 and Department of Labor regulations, U.S. Army Corps of Engineers (USACE) contractors and subcontractors at all tiers are encouraged to promote the training and employment of U.S. veterans while performing under a USACE contract. While no set-aside, evaluation preference, or incentive applies to the solicitation or performance under the resultant contract, USACE contractors are encouraged to seek out highly qualified veterans to perform services under this contract. The following resources are available to assist USACE contractors in their outreach efforts:

U.S. Department of Labor Veterans employment: www.vets.gov/ Federal veteran employment information: www.fedshirevets.gov/index.aspx Veterans’ Employment and Training Service (VETS): http://www.dol.gov/vets/ Veterans Opportunity to Work (VOW) Program: http://benefits.va.gov/vow/ U.S. Army Warrior Transition Command Employment Index:

http://wtc.army.mil/modules/employers/index.html Hiring Our Heroes initiative: www.uschamberfoundation.org/hiring-our-heroes Guide to Hiring Veterans:

www.whitehouse.gov/sites/default/files/docs/white_house_business_council_- _guide_to_hiring_veterans_0.pdf

2. TRUCK REQUIREMENTS. The contractor-provided cab and chassis (referred to herein as the “truck”) shall be a new (i.e. unused and not refurbished) 6X4 Mack Truck Granite series model or equivalent. The truck shall meet or exceed the requirements specified below:

NLT 425 horsepower diesel engine 10 speed w/ OD transmission 1450 pound-feet of torque @1200 RPM

75 MPH top speed 6X4 axle configuration Cruise control Engine brake Heavy-duty reinforced rail suspense 126-inch cab to axle, 228-inch overall wheelbase 18,000-pound front axle 38,000-pound rear axles 54-inch rear axle spacing Locking differentials – driver controlled Air brakes w/ automatic slack adjusters Front tires – 425/65/22.5 radials Rear tires – 11R22.5 radials Towing package – auxiliary air couplings and 7-pin wiring adapter for trailer connections

PTO

Fuel capacity – 50 gallons Electric engine heater – 120 volt Cab mounted air suspension Driver gages (English units) – speedometer/odometer, tachometer w/ hour meter, engine/transmission oil pressure/temperature, coolant temperature, fuel level, voltmeter, air pressure, exhaust pyrometer

Air ride driver’s seat w/ lumbar adjustment and arm rests Adjustable steering column – tilt/telescope Cab air conditioner Power windows Power door locks AM/FM clock radio Color - White

The contractor shall provide at least three (3) (duplicate) sets of operator keys for the truck at the time of delivery. The contractor also shall provide the vehicle title and certificate of origin at the time of delivery. The vehicle title shall be made to “U.S. Army Corps of Engineers, Fort Worth District” (title holder).

3. SUPPORT BODY. The contractor shall provide all materials and labor to build and mount the new support body to the new truck. The main components of the support body are as follows: water tank; tool boxes; diesel fuel tanks; flood lights; ladders; heavy-duty telescopic crane; heavy-duty pintle hook towing hitch; and fold-down table. The support body and tank shall have a minimum capacity of 2,000 U.S. gallons and no more than 2,500 gallons. The tank shall be rectangular in shape and be no more than 2 feet in height, 8 feet in width, and no more than 22 feet long. The support body shall be mounted to the new truck chassis as specified herein.

The water tank and other components of the new support body shall be manufactured and assembled by certified welders (FCAWG D1.1 UNL) and conform to the most current DOT and OSHA standards.

NOTE: Photos provided herein are of a similar truck chassis and support body configuration operated by the U.S. Army Corps of Engineers, Omaha District. These photos are provided for visual aid to illustrate the desired implementation of the contract requirements specified herein.

a. Water Tank: The water tank shall have a minimum capacity of 2,000 gallons, a maximum capacity of 2,500 gallons, and be constructed entirely of ¼-inch steel plate. It shall also have a baffle system and be lined with an EPA interior epoxy coating to prevent corrosion. Fill ports on the tanks shall be on the top and be 3-inch diameter with a female cam-lock. The tank shall have at least one vertical vent pipe. There shall be a minimum of four (4) water discharge ports, located as follows: two (2) discharge ports shall be located at the rear of the vehicle, and one (1) discharge port shall be located on each side of the tank (totaling four (4) (minimum) altogether). All discharge ports shall be 2-inch diameter with 2-inch ball vales and cam-lock fittings on the end. The water tank shall have at least one site gauge. Both sides of the tank shall have cargo tie down rails with stake pockets (1-¾ by 4-¾ inches inside diameter) incorporated into the rail running the entire length of the body for the purpose of tying down drilling equipment on the top of the tank. The top of the tank shall be able to support a minimum of 16,000 lbs of equipment including the crane. The whole support body will be painted white to match the Government furnished truck.

b. Tool Boxes: The support body as completed will have at least two (2) vertical tool boxes and four (4) horizontal boxes (with two (2) boxes ahead of the axles and two (2) behind the axles). All tool boxes shall be constructed out of at least 1/8” steel plate, they all shall have a locking mechanism and keyed alike. All tool boxes will have some sort of weather proof gasket or seal on the doors. The vertical tool boxes shall be mounted behind the cab of the truck, general size shall be approximately 5 feet high, 2 feet wide, and 20 inches deep with the driver side box shelving design being constructed with multiple dividers as such as those illustrated in the pictures below shown on the passenger side and the box illustrated on the driver side built on the passenger side. The horizontal tool boxes will be as large as possible as space permits ahead and behind the back axles and with at least 2 feet of clearance from the ground. Within the horizontal tool boxes some compartments and shelves are required but exact placement and dimensions are left to then contractor to include in the proposal.

c. Diesel Fuel Tanks: Two (2) diesel fuel tanks of a minimum 100 gallon capacity

(each) will be mounted behind the cab and between the vertical tool boxes of the support body. These tanks shall have a powered pumping system with in cab controls. The diesel fuel hose for fueling rigs will be at least ¾-inch dia. x 50 feet in length with an auto shut off nozzle on the end of the hose. The hose will be in a spring loaded reel mounted on top of the tanks. The installation of the diesel fuel tanks shall all be in accordance with the most current applicable DOT and HAZMAT regulations.

d. Floodlights: At a minimum there shall be two (2) manually adjustable floodlights mounted at the highest place on the support body. These floodlights will be an outdoor all-weather 12V 80 watt LED light with in cab control switch.

e. Ladders: At least two (2) ladders shall be affixed to the support body for access to the deck of the truck. Both ladders shall have grab handles to provide stability.

The access ladders shall meet OSHA and DOT standards.

f. Telescopic Crane and Hydraulic Outriggers: The exact specification for the crane mounted to the support body will be an IMT series 7500 Telescopic Crane or equivalent. The exact specifications for the hydraulic outriggers will be an Bigmax Type E Parallel Beam capable of supporting a 10-23 ton lift or equivalent. See crane and outrigger specifications attached below. The crane shall have a 22 foot long boom with maximum lift of 7,500 lbs and 2,045 lbs capacity at maximum reach. The crane will be mounted on top of the deck on the back portion of the passenger side of the body. The pedestal for the crane will be structurally sound to provide the best stability in order to lift the maximum of the crane’s capacity. Once mounted to the support body, all standard features of the IMT 7500 crane and outriggers will be functional through the radio remote controller including starting and shutting down the truck engine while stationary.

Power activation for the crane will be from an in-cab control switch.

g. Heavy-Duty Pintle Hitch: Specification for the towing hitch shall be a Pintle hook with no less than 25-Ton rating. The hitch shall be securely mounted to the frame of the truck to handle this capacity. All other necessities for towing, a 7-pole connector and wiring for lights, and air supply lines shall all be in accordance with DOT regulations.

h. Fold-Down Table: Mounted to the rear of the support body shall be a fold-down working table as wide as the body permits, approximately 8 feet wide and 2 feet deep with a strong (minimum weight capacity of 1,000 lbs.) expanded surface and its hinges securely mounted to the frame. With the addition of the table and other options to the support body all reflective markings, clearance lights, rear tail lights and back-up lights shall be in accordance with DOT requirements.

4. TESTING AND MANUALS. The completed water truck (including support platform) shall be thoroughly tested and ready for immediate and continuous operation when delivered. The truck shall pass all DOT inspections, certification, and be deemed road-ready upon delivery. The vendor shall be required to demonstrate the functions of the telescopic crane to the USACE Fort Worth District drill crew foreman and crew. All owner’s and service manuals as well as parts catalogs shall be furnished at the time of delivery. Two hard copy sets and an electronic PDF version of these documents shall be delivered with the water truck.

5. WARRANTY. Contractor shall provide a comprehensive “bumper-to-bumper” warranty for a period of not less than 1 year after the date of delivery to USACE Fort Worth District for the water truck, to include the truck and all of its components, as well as the support platform and all of its components.

6. DELIVERY

Delivery of the new water truck to USACE Fort Worth District shall be made no later than 180 calendar days after the date of contract award. The new water truck shall be delivered to the following location:

Fort Worth Federal Center Warehouse No. 9 501 W. Felix Street Fort Worth, TX 76115

At a minimum, coordination with the Government regarding this equipment delivery shall include:

a. Point-of-Departure. Telephone and email notification at the time the equipment leaves the contractor facilities for its transportation to Fort Worth. A projection of the delivery date and time at the location specified above shall be provided with this notification. Telephone notification shall be made to the primary notification POC. Email notification shall be made to the primary POC as well as all alternate POCs listed below.

b. Point-of-Delivery. Telephone notification at least 90 minutes in advance of the delivery at the location specified by the Government. It is of critical importance that a live telephone contact (as opposed to voice-mail) be made at this point-of-notification to ensure a Government representative shall be available to receive the equipment. Therefore, if telephone contact cannot be made with the primary POC, alternate POCs shall be notified, in the sequence shown below, until a live telephone contact is made with the Government.

Government Points-of-Contact for Delivery Notification:

Primary:

Loree Baldi Ph.: (817) 886-1808 email: loree.d.baldi@usace.army.mil

Alternates:

Ken McCleskey Ph.: (817) 886-1700 email: ken.mccleskey@usace.army.mil

Dwain Miles Ph.: (817) 886-1471 email: hubert.d.miles@usace.army.mil

Joel Webster Ph.: (817) 694-7336 (cell phone) email: joel.webster@usace.army.mil

7. SUSTAINABILITY:

a. EPA-DESIGNATED PRODUCTS: The contractor shall meet the recycled content requirements set forth by the EPA at:

http://www3.epa.gov/epawaste/conserve/tools/cpg/products/

b. BIOPREFERRED PROGRAM: The contractor shall meet the BioPreferred

Program requirements set forth by the USDA at:

http://www.biopreferred.gov/BioPreferred/faces/pages/ProductCategories.xhtml

PHOTO EXHIBITS. Similar configuration of water truck and support platform, as specified herein, currently operated by the USACE, Omaha District. (Contractor-provided equipment shall be equivalent.)

BID SCHEDULE

Water Truck Bid Schedule

Provide one (1) new water truck to include a newly manufactured truck chassis and built and mounted support body meeting the requirements outlined in the Scope of Work. The contractor shall provide all components described herein, including the truck chassis, and all materials and labor to build and mount the support body; the support body shall include a water tank, crane, tool boxes, and diesel fuel tank to the truck chassis.

Delivery Date: 180 Days After Date of Contract

CLIN Description Quantity Unit Price Extended Price

0001 Truck as Specified in Scope Paragraph 2 1

0002 Crane (Including Assembly) 1

0003 Custom Support Body Construction and Mounting 1

0004 Delivery 1

Total

PPQ

PHASE 1 – VOLUME 1 - TAB D

SECTION 00 22 10 ATTACHMENT 5

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: Prime Contractor Sub Contractor Joint Venture 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: Firm Fixed Price Cost Reimbursement 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 High Med Routine How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)

PAST PERFORMANCE QUESTIONAIRRE

SECTION 00 22 10 - ATTACHMENT 4

NAVFAC/USACE PAST PERFORMANCE

QUESTIONNAIRE

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.

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 CIRCLE 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) 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):

KO STATEMENT

Only a warranted Contracting Officer (either a Procuring Contracting Officer (PCO), or an Administrative Contracting Officer (ACO)), acting within their delegated limits, has the authority to issue modifications or otherwise change the terms and conditions of this contract. If an individual other than the Contracting Officer attempts to make changes to the terms and conditions of this contract you shall not proceed with the change and shall immediately notify the Contracting Officer.

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 1 Job

Funded Amt:

Water Truck Replacement

Provide one (1) new water truck to include a newly manufactured truck chassis and built and mounted support body meeting the requirements in the Scope of Work NOTE: The requirements in DFARS 252.211-7003, Item Identification and Valuation, are applicable for this line item. The contractor shall provide DoD unique identification or a DoD recognized unique identification equivalent.

NAICS CD: 336211

, FSC CD: 2320

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 Destination Government Destination Government

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 180 dys. ADC 1 FORT WORTH FEDERAL CENTER

WAREHOUSE NO.

LOREE BALDI

501 W. FELIX STREET

FORT WORTH TX 76115

(817) 8865-1808 FOB: Destination

CLAUSES INCORPORATED BY REFERENCE

52.203-6 Restrictions On Subcontractor Sales To The Government SEP 2006 52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber

Content Paper

MAY 2011

52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards

OCT 2016

52.204-16 Commercial and Government Entity Code Reporting JUL 2016 52.204-18 Commercial and Government Entity Code Maintenance JUL 2016 52.209-2 Prohibition on Contracting with Inverted Domestic

Corporations--Representation

NOV 2015

52.209-10 Prohibition on Contracting With Inverted Domestic Corporations

NOV 2015

52.211-6 Brand Name or Equal AUG 1999 52.212-1 Instructions to Offerors--Commercial Items JAN 2017 52.212-4 Contract Terms and Conditions--Commercial Items JAN 2017 52.219-6 Notice Of Total Small Business Set-Aside NOV 2011 52.219-8 Utilization of Small Business Concerns NOV 2016 52.219-14 Limitations On Subcontracting JAN 2017 52.219-28 Post-Award Small Business Program Rerepresentation JUL 2013 52.222-3 Convict Labor JUN 2003 52.222-19 Child Labor -- Cooperation with Authorities and Remedies OCT 2016 52.222-21 Prohibition Of Segregated Facilities APR 2015 52.222-26 Equal Opportunity SEP 2016 52.222-35 Equal Opportunity for Veterans OCT 2015 52.222-36 Equal Opportunity for Workers with Disabilities JUL 2014 52.222-37 Employment Reports on Veterans FEB 2016

52.222-40 Notification of Employee Rights Under the National Labor Relations Act

DEC 2010

52.222-50 Combating Trafficking in Persons MAR 2015 52.223-1 Biobased Product Certification MAY 2012 52.223-4 Recovered Material Certification MAY 2008 52.223-18 Encouraging Contractor Policies To Ban Text Messaging

While Driving

AUG 2011

52.225-13 Restrictions on Certain Foreign Purchases JUN 2008 52.232-40 Providing Accelerated Payments to Small Business

Subcontractors

DEC 2013

52.233-4 Applicable Law for Breach of Contract Claim OCT 2004 52.236-23 Responsibility of the Architect-Engineer Contractor APR 1984 52.242-13 Bankruptcy JUL 1995 52.242-15 Stop-Work Order AUG 1989 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7005 Representation Relating to Compensation of Former DoD Officials

NOV 2011

252.204-0002 Line Item Specific: Sequential ACRN Order SEP 2009 252.204-7003 Control Of Government Personnel Work Product APR 1992 252.204-7008 Compliance With Safeguarding Covered Defense Information

Controls

OCT 2016

252.204-7011 Alternative Line Item Structure SEP 2011 252.204-7015 Notice of Authorized Disclosure of Information for Litigation

Support

MAY 2016

252.209-7004 Subcontracting With Firms That Are Owned or Controlled By The Government of a Country that is a State Sponsor of Terrorism

OCT 2015

252.211-7008 Use of Government-Assigned Serial Numbers SEP 2010 252.223-7008 Prohibition of Hexavalent Chromium JUN 2013 252.225-7001 Buy American And Balance Of Payments Program-- Basic

(Dec 2016)

DEC 2016

252.225-7002 Qualifying Country Sources As Subcontractors DEC 2016 252.225-7012 Preference For Certain Domestic Commodities DEC 2016 252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

JUN 2012

252.232-7010 Levies on Contract Payments DEC 2006 252.243-7002 Requests for Equitable Adjustment DEC 2012 252.247-7023 Transportation of Supplies by Sea APR 2014

CLAUSES INCORPORATED BY FULL TEXT

52.209-6 PROTECTING THE GOVERNMENT'S INTEREST WHEN SUBCONTRACTING WITH

CONTRACTORS DEBARRED, SUSPENDED, OR PROPOSED FOR DEBARMENT (OCT 2015)

(a) Definition. Commercially available off-the-shelf (COTS) item, as used in this clause--

(1) Means any item of supply (including construction material) that is--

(i) A commercial item (as defined in paragraph (1) of the definition in FAR 2.101);

(ii) Sold in substantial quantities in the commercial marketplace; and

(iii) Offered to the Government, under a contract or subcontract at any tier, without modification, in the same form in which it is sold in the commercial marketplace; and

(2) Does not include bulk cargo, as defined in 46 U.S.C. 40102(4), such as agricultural products and petroleum products.

(b) The Government suspends or debars Contractors to protect the Government's interests. Other than a subcontract for a commercially available off-the-shelf item, the Contractor shall not enter into any subcontract, in excess of $35,000 with a Contractor that is debarred, suspended, or proposed for debarment by any executive agency unless there is a compelling reason to do so.

(c) The Contractor shall require each proposed subcontractor whose subcontract will exceed $35,000, other than a subcontractor providing a commercially available off-the-shelf item, to disclose to the Contractor, in writing, whether as of the time of award of the subcontract, the subcontractor, or its principals, is or is not debarred, suspended, or proposed for debarment by the Federal Government.

(d) A corporate officer or a designee of the Contractor shall notify the Contracting Officer, in writing, before entering into a subcontract with a party (other than a subcontractor providing a commercially available off-the-shelf item) that is debarred, suspended, or proposed for debarment (see FAR 9.404 for information on the System for Award Management (SAM) Exclusions). The notice must include the following:

(1) The name of the subcontractor.

(2) The Contractor's knowledge of the reasons for the subcontractor being listed with an exclusion in SAM.

(3) The compelling reason(s) for doing business with the subcontractor notwithstanding its being listed with an exclusion in SAM.

(4) The systems and procedures the Contractor has established to ensure that it is fully protecting the Government's interests when dealing with such subcontractor in view of the specific basis for the party's debarment, suspension, or proposed debarment.

(e) Subcontracts. Unless this is a contract for the acquisition of commercial items, the Contractor shall include the requirements of this clause, including this paragraph (e) (appropriately modified for the identification of the parties), in each subcontract that--

(1) Exceeds $35,000 in value; and

(2) Is not a subcontract for commercially available off-the-shelf items.

(End of clause)

52.212-2 EVALUATION--COMMERCIAL ITEMS (OCT 2014)

(a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:

Factor 1: Price Factor 2: Past Performance

Factor 1: Quotes will be ranked from lowest price to highest price and beginning with the lowest price first, quotes will then be evaluated to ensure prices are fair and balanced. Award shall not be made to an Offeror’s quote that is found to be unbalanced and/or unreasonably low or high.

Factor 2: Past Performance will be verified by the use of the Past Performance Questionnaire (provided in the solicitation) and other government systems (PPIRS, SAM, etc…). Quotes will be assigned a rating of Positive, Neutral or Negative with a lack of past performance receiving a rating of Neutral. OFFERS

WILL NOT BE EXCLUDED DUE TO A LACK OF PAST PERFORMANCE.

If an offer is found to be the lowest price but has a “Negative” past performance rating the Contracting Officer will proceed to the next lowest quote. If an offer is found to be the lowest priced offer with either a “Positive” or “Neutral” past performance rating the Contracting Officer will proceed with the award and no other offer will be evaluated.

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s).

(c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

(End of provision)

52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS--COMMERCIAL ITEMS (JAN 2017)

ALTERNATE I (OCT 2014)

The offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) Web site located at https://www.sam.gov/portal . If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (u) of this provision.

(a) Definitions. As used in this provision--

“Administrative merits determination” means certain notices or findings of labor law violations issued by an enforcement agency following an investigation. An administrative merits determination may be final or be subject to appeal or further review. To determine whether a particular notice or finding is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“Arbitral award or decision” means an arbitrator or arbitral panel determination that a labor law violation occurred, or that enjoined or restrained a violation of labor law. It includes an award or decision that is not final or is subject to being confirmed, modified, or vacated by a court, and includes an award or decision resulting from private or confidential proceedings. To determine whether a particular award or decision is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“Civil judgment” means--

(1) In paragraph (h) of this provision: A judgment or finding of a civil offense by any court of competent jurisdiction.

(2) In paragraph (s) of this provision: Any judgment or order entered by any Federal or State court in which the court determined that a labor law violation occurred, or enjoined or restrained a violation of labor law. It includes a judgment or order that is not final or is subject to appeal. To determine whether a particular judgment or order is covered by this definition, it is necessary to consult section II.B. in the DOL Guidance.

“DOL Guidance” means the Department of Labor (DOL) Guidance entitled: ``Guidance for Executive Order 13673, `Fair Pay and Safe Workplaces' ''. The DOL Guidance, dated August 25, 2016, can be obtained from www.dol.gov/fairpayandsafeworkplaces.

“Economically disadvantaged women-owned small business (EDWOSB) concern” means a small business concern that is at least 51 percent directly and unconditionally owned by, and the management and daily business operations of which are controlled by, one or more women who are citizens of the United States and who are economically disadvantaged in accordance with 13 CFR part 127. It automatically qualifies as a women-owned small business eligible under the WOSB Program.

“Enforcement agency” means any agency granted authority to enforce the Federal labor laws. It includes the enforcement components of DOL (Wage and Hour Division, Office of Federal Contract Compliance Programs, and Occupational Safety and Health Administration), the Equal Employment Opportunity Commission, the occupational Safety and Health Review Commission, and the National Labor Relations Board. It also means a State agency designated to administer an OSHA-approved State Plan, but only to the extent that the State agency is acting in its capacity as administrator of such plan. It does not include other Federal agencies which, in their capacity as contracting agencies, conduct investigations of potential labor law violations. The enforcement agencies associated with each labor law under E.O. 13673 are--

(1) Department of Labor Wage and Hour Division (WHD) for--

(i) The Fair Labor Standards Act;

(ii) The Migrant and Seasonal Agricultural Worker Protection Act;

(iii) 40 U.S.C. chapter 31, subchapter IV, formerly known as the Davis-Bacon Act;

(iv) 41 U.S.C. chapter 67, formerly known as the Service Contract Act;

(v) The Family and Medical Leave Act; and

(vi) E.O. 13658 of February 12, 2014 (Establishing a Minimum Wage for Contractors);

(2) Department of Labor Occupational Safety and Health Administration (OSHA) for--

(i) The Occupational Safety and Health Act of 1970; and

(ii) OSHA-approved State Plans;

(3) Department of Labor Office of Federal Contract Compliance Programs (OFCCP) for--

(i) Section 503 of the Rehabilitation Act of 1973;

(ii) The Vietnam Era Veterans' Readjustment Assistance Act of 1972 and the Vietnam Era Veterans' Readjustment Assistance Act of 1974; and

(iii) E.O. 11246 of September 24, 1965 (Equal Employment Opportunity);

(4) National Labor Relations Board (NLRB) for the National Labor Relations Act; and

(5) Equal Employment Opportunity Commission (EEOC) for--

(i) Title VII of the Civil Rights Act of 1964;

(ii) The Americans with Disabilities Act of 1990;

(iii) The Age Discrimination in Employment Act of 1967; and

(iv) Section 6(d) of the Fair Labor Standards Act (Equal Pay Act).

“Forced or indentured child labor” means all work or service—

(1) Exacted from any person under the age of 18 under the menace of any penalty for its nonperformance and for which the worker does not offer himself voluntarily; or

(2) Performed by any person under the age of 18 pursuant to a contract the enforcement of which can be accomplished by process or penalties.

“Highest-level owner” means the entity that owns or controls an immediate owner of the offeror, or that owns or controls one or more entities that control an immediate owner of the offeror. No entity owns or exercises control of the highest level owner.

“Immediate owner” means an entity, other than the offeror, that has direct control of the offeror. Indicators of control include, but are not limited to, one or more of the following: Ownership or interlocking management, identity of interests among family members, shared facilities and equipment, and the common use of employees.

“Inverted domestic corporation,” means a foreign incorporated entity that meets the definition of an inverted domestic corporation under 6 U.S.C. 395(b), applied in accordance with the rules and definitions of 6 U.S.C. 395(c).

“Labor compliance agreement” means an agreement entered into between a contractor or subcontractor and an enforcement agency to address appropriate remedial measures, compliance assistance, steps to resolve issues to increase compliance with the labor laws, or other related matters.

“Labor laws” means the following labor laws and E.O.s:

(1) The Fair Labor Standards Act.

(2) The Occupational Safety and Health Act (OSHA) of 1970.

(3) The Migrant and Seasonal Agricultural Worker Protection Act.

(4) The National Labor Relations Act.

(5) 40 U.S.C. chapter 31, subchapter IV, formerly known as the Davis-Bacon Act.

(6) 41 U.S.C. chapter 67, formerly known as the Service Contract Act.

(7) E.O. 11246 of September 24, 1965 (Equal Employment Opportunity).

(8) Section 503 of the Rehabilitation Act of 1973.

(9) The Vietnam Era Veterans' Readjustment Assistance Act of 1972 and the Vietnam Era Veterans' Readjustment Assistance Act of 1974.

(10) The Family and Medical Leave Act.

(11) Title VII of the Civil Rights Act of 1964.

(12) The Americans with Disabilities Act of 1990.

(13) The Age Discrimination in Employment Act of 1967.

(14) E.O. 13658 of February 12, 2014 (Establishing a Minimum Wage for Contractors).

(15) Equivalent State laws as defined in the DOL Guidance. (The only equivalent State laws implemented in the FAR are OSHA-approved State Plans, which can be found at www.osha.gov/dcsp/osp/approved_state_plans.html).

“Labor law decision” means an administrative merits determination, arbitral award or decision, or civil judgment, which resulted from a violation of one or more of the laws listed in the definition of ``labor laws''.

“Manufactured end product” means any end product in product and service codes (PSCs) 1000-9999, except—

(1) PSC 5510, Lumber and Related Basic Wood Materials;

(2) Product or Service Group (PSG) 87, Agricultural Supplies;

(3) PSG 88, Live Animals;

(4) PSG 89, Subsistence;

(5) PSC 9410, Crude Grades of Plant Materials;

(6) PSC 9430, Miscellaneous Crude Animal Products, Inedible;

(7) PSC 9440, Miscellaneous Crude Agricultural and Forestry Products;

(8) PSC 9610, Ores;

(9) PSC 9620,…