REVISED - EXHIBIT_C_-_Readiness_Center_Bangor_TS.doc

Readiness Center, Bangor TS, Bangor, Maine

W912JD-12-R-0002

EXHIBIT C PACKAGE INFORMATION AND FORMS

Instructions to Offeror for sending Reference Questionnaire Forms: Prepare and send a reference questionnaire package for each project listed on your Exhibit A, Performance Information Form. For Government contracts, send to Contracting Officer or Technical Representative. For commercial references send to personnel with duties similar to those for Government contracts. It is your responsibility to follow-up and to encourage your references to send in their questionnaire. If you have multiple references at one location (Base etc.) send one cover letter and questionnaires for each contract you want a reference for. Your questionnaire package should contain the following.

1. Cover Letter (See SAMPLE)

2. Respondent Info Rating Sheets Offeror should put name in spaces indicated and ensure it is on every page for identification purposes

3. Suggested Pre Addressed stamped envelope.

OFFEROR DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

EXHIBIT C

SAMPLE TRANSMITTAL LETTER

AND

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Insert Your Company Letterhead

Date: _________________

To: ______________________________________

We have listed your firm as a reference for work we have performed for you Our firm intends to submit a proposal under a project advertised by the USPFO for Maine, Augusta, Maine. 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 (include the following if more than one questionnaire is sent to an organization or delete). Furthermore, a questionnaire has also been sent to ____________________ of your organization. Only one response from each office is required. If at all possible, we suggest that you individually answer this questionnaire and then coordinate your responses with that of ________________________, to forge a consensus on one overall response from your organization.

Please send your completed questionnaire to the following address to arrive NOT LATER

THAN 15 May 2012, the date and time set for receipt of Phase I proposals. Do not return them to our company.

If you have questions regarding the attached questionnaire, or require assistance, please contact Darlene Howes at 207-430-5608 email darlene.howes@us.army.mil Thank you for your assistance.

Signature and Title

PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Upon completion of this form and the questionnaire please send directly to the following:

USPFO for Maine, Purchase and Contracting Office ATTN: Darlene Howes W912JD-12-R-0002 Bldg 39, Camp Keyes

Augusta, Maine 04333

E-Mail: darlene.howes@us.army.mil

FAX: 207-430-5608.

Do not return this form to offeror’s office. Return this page with Questionnaire to Contracting Officer

RESPONDENT IDENTIFICATION AND RATINGS

(Part 1 Contractor submitting Proposal fill-in) Reference is provided for: ________________________________Prime____ or Subcontractor____

Subcontractor provide name of Prime contractor proposing ____________________.

Contract Number or Project Title______________________________________________________

Date of Award ________________________Completion Date______________________________

If not complete provide percentage complete _____________________________________

Location_________________________________________________________________________

Dollar Amount of Award__________________ Final or Current ____________________________

Brief Description of work and your role in the referenced contract: ___________________________

(Part 2 Person providing Reference) Reference is provided by: ___________________________

Company/Agency: _________________________________________________________________

Business Address; ________________________________________________________________

Telephone Number: _______________________________________________________________

E-Mail Address: __________________________________________________________________

Relationship to Contract: ___________________________________________________________

If information above (Part 1) is not accurate please indicate.

To obtain an electronic version of the form please contact: Darlene Howes at 207-430-5608 or email darlene.howes@us.army.mil.

SOURCE SELECTION SENSITIVE WHEN COMPLETED

Please mark the appropriate rating. Use the rating chart on the last page. Include the name of the company the reference is for on each page. Please provide remarks so we can better understand you rating.

(1) Quality Control (QC) (Design and or Construction) –To what extent did the contractor provide:

Quality Workmanship

REMARKS:

(2) Timely Performance (Design and or Construction) – To what extent did the contractor:

Resolve delays in an expeditious manner

Identify/correct deficient work in a timely manner

Process submittals in a timely manner

Provided timely submission of close out documents

Provided timely and satisfactory response to warranty issues after project completion (NA- A&E)

Provide timely solutions to design defects or omissions (NA Construction)

REMARKS:

(3) Management Effectiveness

(3a) General Business Practices- To what extent did the contractor:

Cooperated to resolve problems, attending meetings (as applicable) and maintained communication to assure satisfactory resolution

REMARKS:

(3b) Subcontractor Management-To what extent did the contractor:

REMARKS:

(3c) Pricing-To what extent did the contractor:

Submit proposals that accurately represented the work required

Provide accurate, complete, and reasonable price/cost information for modifications (not over inflated or under estimated)

REMARKS:

(3d) Site Management/Superintendent/Designer Involvement- To what extent did the contractors site management/superintendent/designer:

Ensure compliance to contract requirements

REMARKS:

(4) Compliance with Federal laws and Regulations (Design and Construction)- To what extent did the contractor:

Comply with labor laws and regulations with specific attention to Davis-Bacon Act (NA A&E)

(Where payrolls complete and correct and submitted in a timely manner)

Comply with Drug Free Work Place requirements – (NA A&E)

Comply with Executive Order 13101- Use of Recovered Material (Affirmative Procurement)

REMARKS:

(5) Compliance with Safety Standards (Construction Only)- To what extent did the contractor:

Implement and adequate safety plan

REMARKS:

(6) Compliance with Small Business Concerns and/or Small Business Contracting Plan Requirements- To what extent did the contractor provide:

Adequate Utilization of Small Business Concerns, FAR 52.219-8 clause requirements (This is applicable to all offerors) (This will be rated neutral if no Government contracts)

Information that indicates that the offeror has adequately utilized Small Businesses in accordance with FAR 52.219-8 on previous contracts

(Applicable to large businesses offerors only) Adequate compliance with Small Business Subcontracting Plan requirements (FAR 52.219-9). Were goals achieved and, if not, were reasons considered adequate to mitigate future performance risk acceptable.

REMARKS:

(7) Other Past Performance Considerations

(7a) How would you rate the Contractor’s overall performance?

CUSTOMER SATISFACTION:

To what extent were the end users satisfied with:

Quality? Cost? Schedule?

Exceptionally Satisfied Q____ C_____S____

Highly Satisfied

Q____ C_____S____

Satisfied

Q____ C_____S____

Somewhat Dissatisfied Q____ C_____S____ (explain please)

REMARKS:

(7b) What were the contractor’s top documented strengths, if any, in performing the contract requirements?

REMARKS:

(7c) Please Provide Any Additional Information You Feel Is Important Not Covered Elsewhere:

REMARKS:

Thank you for your remarks. Please ensure that you return this questionnaire to the Contracting Agency. Do NOT return to the evaluated contractor. Be sure to include the information page.

Reference provided by ________________________________ DATE:________________

RATING DEFINITION CHART