EXHIBIT_C.doc

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Remote Piloted Aircraft Beddown, Building 912
Solicitation number
W912PQ-16-R-0005
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W912PQ-16-R-0005 - Project # RVKQ139005 Remotely Piloted Aircraft Beddown, Bldg. 912.

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 107th Airlift Wing 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. 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 11:00 A.M. on 28 June 2016. Do not return them to our company.

Base Contracting Office

107th Airlift Wing

9910 Blewett Ave, Bldg 901, Rm 102

Niagara Falls ANG Base, NY 14304 Email: jason.m.fronden.mil@mail.mil Thank you for your assistance. E-Mail is preferred.

Signature and Title

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

RATING
DEFINITION
Outstanding (O)
Performance meets contractual requirements and exceeds many requirements that benefit the end user. Work was accomplished with few, if any, minor problems for which corrective actions taken by the contractor were highly effective.
Good:
Performance meets contractual requirements and exceeds some requirements that benefit the end user. Work was accomplished with some minor problems for which corrective actions taken by the contractor were effective.
Acceptable
Performance meets contractual requirements. Work was accomplished with some minor problems for which corrective actions taken by the contractor were satisfactory.
Marginal (M)
Performance does not meet some contractual requirements. Serious problems with contractor performance were experienced for which the contractor has either not yet identified corrective actions or the corrective actions taken appear only marginally effective.
Unacceptable (U)
Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.
Unknown or Not Applicable (N/A)
The question does not apply. No performance record identifiable within the area of evaluation.

THE QUESTIONNAIRE SHOULD BE SUBMITTED BY THE FOLLOWING MEANS:

Return via email to the email address shown above.

Mark cover sheet: (Attention: RFP W912PQ-16-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:

Dollar Value:
$

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 Subfactors by placing an X in the appropriate column that corresponds to the rating definitions on the previous page.

QUALITY CONTROL

Outstanding
Good
Acceptable
Marginal
Unsatisfactory
Not Applicable
(O)
(G)
(A)
(M)
(U)
(N/A)

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

(O)
(G)
(A)
(M)
(U)
(N/A)

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

(O)
(G)
(A)
(M)
(U)
(N/A)

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

Comments on Effectiveness of Management:

COMPLIANCE WITH LABOR STANDARDS

(O)
(G)
(A)
(M)
(U)
(N/A)

Correction of Noted Deficiencies

Payrolls Properly Completed and Submitted

Comments on Compliance:

COMPLIANCE WITH SAFETY STANDARDS

(O)

(G)

(A)

(M)

(U)

(N/A)

Adequacy of Safety Plan Safety History Comments on Safety Standards:

OVERALL RATING of PERFORMANCE
(O)
(G)
(A)
(M)
(U)
(N/A)

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

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 ________________________________

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