DOMOPS_Exhibit_C_SSS__SA_and_UR_Mar_2013.doc

EXHIBIT C PACKAGE INFORMATION AND FORMS

EXHIBIT C PACKAGE INFORMATION AND FORMS - A “Final” Performance Evaluation (Construction) ( also referred to as CCASS Evaluation ) issued for a project may be included in lieu of sending out reference package for the project. Place the CCASS form directly behind the Exhibit A it is applicable to.

Instructions to Offeror for sending Reference Questionnaire Forms: Prepare and submit to the owners of the projects listed in your Exhibit A “Performance Relevancy Questionnaires”, a Reference Package (Exhibit C). For Government contracts, send to 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 Officer in a timely manner. If you have multiple references at one location (Base 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 SAMPLE) (Exhibit C1)

Respondent Info Rating Sheets (Exhibit C2)(the next 5 pages) - Offeror should put name in spaces indicated and ensure it is on every page for identification purposes.

Suggested - Pre Addressed stamped envelope to return to Contracting Officer.

OFFEROR SHOULD PLACE THEIR NAME ON TOP OF EACH QUESTIONNAIRE PAGE!!!

OFFEROR SHOULD DELETE THESE INSTRUCTIONS BEFORE SENDING OUT QUESTIONNAIRES

EXHIBIT C1

SAMPLE TRANSMITTAL LETTERAND PAST PERFORMANCE EVALUATION QUESTIONNAIRE

Your Company Letterhead

Date: _________________

To: ______________________________________

We have listed your firm as a reference for the work we have performed for you as listed below. Our firm has submitted a proposal under a project advertised by the 175 MSG/MSC Base Contracting Office, Maryland Air National Guard. 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. A completed CCASS Evaluation for a DoD project or similar Agency appraisal form may be substituted for this reference questionnaire. 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.

Please send your completed questionnaire to the following address to arrive NOT LATER THAN 28 Aug 2014. Do not return them to our company.

Maryland Air National Guard Base Contracting Office

W912K6-14-R-0005

2701 Eastern Blvd

Middle River, MD 21220

If you have questions regarding the attached questionnaire, or require assistance, please contact MSgt Michael Dombkiewicz at 410-918-6218 or email to: 175.wg.msc@anf.af.mil. Thank you for your assistance. E-Mail is required.

Signature and Title

RATING DESCRIPTIONS: Use the following descriptions as guidance in providing ratings.

THE QUESTIONNAIRE SHOULD BE SUBMITTED BY THE FOLLOWING MEANS:

Return via email to the email address shown above. Forms may be mailed to Maryland Air National Guard, Base Contracting Office, 2701 Eastern BLVD, Baltimore, MD 21220 Mark cover sheet: (Attention: RFP W912K6-14-R-0005 “Source Selection Sensitive Information”)

SOURCE SELECTION SENSITIVE WHEN COMPLETED

*****NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS*****

(Exhibit C2) RESPONDENT IDENTIFICATION AND RATINGS (Part 1 Contractor submitting Proposal fill-in)

RESPONDENT IDENTIFICATION AND RATINGS

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

Contract Number:

Project Title:

Date of Award:

Project Completion Date:

Project Location:

Brief Description of Proj:

Your role in referenced contract:

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

Company/Agency:

Business Address:

Telephone Number:

Email Address:

Project Completion Date:

Relationship to Contract:

If information in Part I is not accurate please indicate.

SOURCE SELECTION SENSITIVE WHEN COMPLETED

*****NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS*****

OFFEROR NAME ________________________________Please circle the appropriate rating.

Please provide evaluation of the following Performance Elements by placing an X in the appropriate column that corresponds to the rating definitions on the previous page.

QUALITY CONTROL

Quality of Workmanship

Adequacy of the quality control plan

Implementation of the Quality Control Plan

Quality of the Quality Control Documentation

Storage of Materials

Adequacy of Materials

Adequacy of Submittals

Adequacy of Quality Control Testing

Adequacy of As-Builts

Use of Specified Materials

Identification/Correction of Deficient work in a timely manner

Comments on Quality Control:

TIMELY PERFORMANCE

Adequacy of Initial Progress Schedule

Adherence to Approved Schedule

Resolution of Delays

Submission of Required Documentation

Completion of Punchlist Items

Submission of Updated and Revised Progress Schedules

Warranty Response

Comments on Timely Performance:

EFFECTIVENESS OF MANAGEMENT

Cooperation and Responsiveness

Management of Resources/Personnel

Coordination and Control of Subcontractors

Adequacy of Site Clean Up

Effectiveness of Job-Site Supervision

Compliance with Laws and Regulations

Professional Conduct

Review/Resolution of Subcontractor Issues

Implementation of Subcontracting Plan

Comments on Effectiveness of Management:

COMPLIANCE WITH LABOR STANDARDS

Correction of Noted Deficiencies

Payrolls Properly Completed and Submitted

Compliance with Labor Laws and Regulations with Specific Attention to the Davis-Bacon Act and EEO Requirements

Comments on Compliance With Labor Standards:

COMPLIANCE WITH SAFETY STANDARDS

Adequacy of Safety Plan

Implementation of Safety Plan

Correction of Noted Deficiencies

Comments on Compliance With Safety Standards:

Please provide any additional information you feel is important and not covered elsewhere in this evaluation:

How effective was the contractor in meeting the contract’s sustainability requirements?

IF USGBC LEED® rating was required indicated level specified and level achieved in remarks.

Thank you for your remarks. Be sure to return to the Contracting Agency and not to the Contractor you are providing a reference for.

NAME__________________________________Contact Phone Number:____________________________

Respondent Signature ______________________________________Date Completed:_______________

SOURCE SELECTION SENSITIVE WHEN COMPLETED

*****NOT TO BE RELEASED OUTSIDE GOVERNMENT CHANNELS*****

OFFEROR NAME ________________________________