Nav Data Sheet and Evaluation Questionnaires.docx

USACE St. Paul District June 2009

USACE St. Paul District July 2009

ATTACHMENT 1 - PHASE ONE PROPOSAL DATA SHEET (TAB A)

LOCK AND DAM #3 NAVIGATION IMPROVEMENTS

Name of Offeror[footnoteRef:1]: [1: The Offeror is the business entity that you anticipate will submit a response to the Request for Proposals if selected to participate in Phase II of this procurement. In the event that the “Offeror” business entity has not yet been formed (e.g. a project specific joint venture), please note that and submit qualification information on that prospective business entity. The components of a prospective business entity must be described with specificity; alternative business entities will not be considered.

Address:

Phone:

Fax:

E-mail:

DUNS # (used for accessing the Construction Contractor Appraisal Support System (CCASS) or A/E Contractor Administration Support System (ACASS) Database):

If a separate DUNS number has been created for a Joint Venture (JV) it must also be submitted. Provide a DUNS number for each entity identified in any proposed teaming arrangement, joint venture, or contractor-subcontractor association of firms. If the Offeror is a JV or a constructor/designer or contractor-subcontractor arrangement, list the component entities by name and briefly describe the nature of the association, including at a minimum the prime contractor and designer of record. Also provide any other assigned number that identifies the Offeror (or its component entities) in the ACASS or CCASS databases.

AUTHORIZED POINTS OF CONTACT (POC)

The Offeror represents that the following persons are authorized to communicate on its behalf with the Government in connection with this Request for Qualifications (RFQ).

[List names, titles, and telephone number of the POC.]

Name of POC:

POC’s Address:

POC’s Telephone and Email:

RFQ AMENDMENTS (Number and date of acknowledgement)

By responding to this Request for Quotation, the signatory represents that:

a. he or she is authorized to bind the Offeror (or, in the case of a business entity that is not yet formed, that he/she has been authorized in writing by all of the component entities to submit this RFQ response on their behalf);

b. the business entity identified as the Offeror in this RFQ response is the business entity that will provide a price/technical proposal in response to Phase II of this procurement if requested to participate in that phase; and

c. the Offeror intends to provide a price/technical proposal in response to Phase II of this procurement if requested to do so.

Name of Offeror (typed above)

By: ________________________________________________ (signature) Name of Representative (typed):___________________________________ Relationship of Representative to Offeror: ___________________________[footnoteRef:2] [2: If the Offeror is an existing business entity, provide the title of the signatory (e.g. President, CEO, Managing Partner). If the Offeror is a business entity that is yet to be formed, insert “Authorized Representative” into the blank in accordance with a. above.]

ATTACHMENT 2 - PAST PERFORMANCE EVALUATION QUESTIONAIRE: DESIGN (TAB C)

1. Lead Architect or Architect Engineer/Name & Address (city and state): ___________________________________________________________________________

2. Contractor/Name & Address (if Design-Build): _____________________________________

3. Type of Contract: Fixed Price ___________ Cost Reimbursement _____________ Other (specify) _________________________________________

4. Title of Project/Contract Number:

5. Description of Work:

6. Complexity of Work: High _______________ Mid _____________ Routine ______________

7. Location of Work: ____________________________________________________________

8. Date of Award: ______________________________________________________________

9. Status: Active __________________ (please provide percent complete) Complete _________________ (please provide date complete)

10. Name and telephone number of Owner’s Technical Representative:

QUALITY OF PRODUCT/SERVICE:

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality

Remarks: ________________________________________________________________________

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality Problems

CUSTOMER SATISFACTION:

15. To what extent were the end users satisfied with:

Exceptionally Satisfied

Highly Satisfied

Satisfied

Somewhat Dissatisfied

Highly Dissatisfied

TIMELINESS OF PERFORMANCE:

Completed on Schedule with no time delays

Completed with minor delays or experienced significant delays with extenuating circumstances

Experienced significant delays without justification

Remarks: ________________________________________________________________________

18. Please use the space below to provide other information related to the contractor’s performance. This may include the contractor’s selection and management of subcontractors, flexibility in dealing with contract challenges, their overall concern for the Owner’s interest, project awards received, etc.

19. Rating Official Information Name ____________________________________________ Title _____________________________________________ Office ____________________________________________ Telephone Number (with area code) ___________________ Date _____________________________________________ Signature of Rating Official ___________________________________________________

Thank you for your evaluation. Please submit this completed form to the following address, to be received by 2:00 PM on August 17, 2009:

U.S. Army Corps of Engineers, St. Paul District Sibley Square at Mears Park ATTN: Patricia M. Simon 190 5th Street East, Suite 401 St. Paul, MN 55101-1638

ATTACHMENT 3

PAST PERFORMANCE EVALUATION QUESTIONAIRE: CONSTRUCTION (TAB C)

1. Contractor/Name & Address (city and state): ______________________________________

2. Lead Architect or Architect-Engineer/Name & Address (if Design-Build): ________________

3. Type of Contract: Fixed Price ___________ Cost Reimbursement _____________ Other (specify) ________________________________________

4. Title of Project/Contract Number:

5. Description of Work:

6. Complexity of Work: High _______________ Mid _____________ Routine ______________

7. Location of Work: ____________________________________________________________

8. Date of Award: ______________________________________________________________

9. Status: Active __________________ (please provide percent complete) Complete _________________ (please provide date complete)

10. Name and telephone number of Owner’s Technical Representative:

QUALITY OF PRODUCT/SERVICE:

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality Problems

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality Problems

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality Problems

Good Quality

Satisfactory Quality

Marginal Quality

Unsatisfactory Quality Problems

CUSTOMER SATISFACTION:

15. To what extent were the end users satisfied with:

Exceptionally Satisfied

Highly Satisfied

Satisfied

Somewhat Dissatisfied

Highly Dissatisfied

TIMELINESS OF PERFORMANCE:

Completed on Schedule with no time delays

Completed with minor delays or experienced significant delays with extenuating circumstances

Experienced significant delays without justification

Remarks: ________________________________________________________________________

18. Please use the space below to provide other information related to the contractor’s performance. This may include the contractor’s selection and management of subcontractors, flexibility in dealing with contract challenges, their overall concern for the Owner’s interest, project awards received, etc.

19. Rating Official Information Name ____________________________________________ Title _____________________________________________ Office ____________________________________________ Telephone Number (with area code) ___________________ Date _____________________________________________ Signature of Rating Official ___________________________________________________

Thank you for your evaluation. Please submit this completed form to the following address, to be received by 2:00 PM on August 17, 2009:

U.S. Army Corps of Engineers, St. Paul District Sibley Square at Mears Park ATTN: Patricia M. Simon 190 5th Street East, Suite 401 St. Paul, MN 55101-1638 Lock and Dam #3 Navigation Improvements Solicitation No. W912ES-09-R-0025 Section 00 11 00, Page 1 Lock and Dam #3 Navigation Improvements Solicitation No. W912ES-09-R-0025 Section 00 11 00, Page 2