W912QG-16-R-0002-0005.pdf

0010793637-0002

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

This amendment is issued IAW FAR 15.206(a) to amend the follow ing:

1. Section K.

a. Added DFARS Provision 252.209-7991(DEV) Representation by Corporations Regarding an Unpaid Delinquent Tax Liability or a Felony Conviction under any Federal Law ---Fiscal Year 2016 Appropriations (Deviation 2016-O0002)(Oct 2015).

2. Section L, paragraph L2, Proposal Preparation Instructions has been revised.

Nothing Follow s.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 12

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 14-Jul-2016

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X W912QG-16-R-0002

X 9B. DATED (SEE ITEM 11)

16-Jun-2016

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer is extended, X is not extended.

Offer must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing Items 8 and 15, and returning 0 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(B).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

13-Jul-2016

CODE

USPFO FOR SOUTH CAROLINA

9 NATIONAL GUARD ROAD

COLUMBIA SC 29201-4763

W912QG 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W912QG-16-R-0002

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION K - REPRESENTATIONS, CERTIFICATIONS AND OTHER STATEMENTS OF OFFERORS

The following have been added by full text:

252.209-7991(DEV)

252.209-7991 Representation by Corporations Regarding an Unpaid Delinquent Tax Liability or a Felony Conviction under any Federal Law—

Fiscal Year 2016 Appropriations. (DEVIATION 2016-O0002) (OCT 2015)

(a) In accordance with section 101(a) of the Continuing Appropriations Act, 2016 (Pub.

L. 114-53) and any subsequent FY 2016 appropriations act that extends to FY 2016 funds the same restrictions as are contained in sections 744 and 745 of division E, title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235), none of the funds made available by this or any other Act may be used to enter into a contract with any corporation that—

(1) Has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability, where the awarding agency is aware of the unpaid tax liability, unless the agency has considered suspension or debarment of the corporation and made a determination that this further action is not necessary to protect the interests of the Government; or

(2) Was convicted of a felony criminal violation under any Federal law within the preceding 24 months, where the awarding agency is aware of the conviction, unless the agency has considered suspension or debarment of the corporation and made a determination that this action is not necessary to protect the interests of the Government.

(b) The Offeror represents that—

(1) It is [ ] is not [ ] a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability,

(2) It is [ ] is not [ ] a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO BIDDERS

The following have been modified:

INSTRUCTIONS TO BIDDERS

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO BIDDERS

L1 SUBMISSION OF PROPOSALS

a. All proposals must be delivered to be received at the following address not later than 20 July 2016, 4:00 P.M.

(1600hrs) Eastern Time:

United States Property & Fiscal Office ATTN: Purchasing & Contracting (Mr Cromer) 9 National Guard Road Columbia, S.C. 29201

b. All hand-carried deliveries shall be brought to the USP&FO. Call (803)299-1537 or (803)299-1450 to make arrangements for entry onto the complex.

c. The normal business hours for the South Carolina Army National Guard (SCARNG) are from 7:30 a.m. to 5:00 p.m, Eastern time. The SCARNG does work an alternating work schedule and is closed every other Monday.

L2 PROPOSAL PREPARATION INSTRUCTIONS

1. Introduction. The offeror’s proposal shall be submitted in hard copy, with accompanying digital copies, as set forth below. The RFP shall provide the Government address and receipt date for proposal submittal.

The offeror’s proposal shall consist of five (4) volumes. The Volumes are I –Deliverables, II - Cost/Price, III – Past Performance, and IV – Representations, Certifications & Other Statements. Files shall not contain classified data.

The use of hyperlinks in proposals is prohibited.

Offerors are cautioned that “parroting” of the PWS with a statement of intent to perform does not reflect an understanding of the requirement or capability to perform. Offerors are responsible for including sufficient details to permit a complete and accurate evaluation of each proposal. Proprietary information shall be clearly marked.

2. PROPOSAL SUBMISSION REQUIREMENTS

a. Each volume shall be submitted in a separate three-ring binder. Any pages that are changed (as a result of negotiations or proposal revisions) should be of a different color and have changed information clearly marked by a vertical line in the right margin of the page. The revised pages shall be dated. Each binder shall be clearly labeled with its Title and a copy number (e.g., copy 1 of 4).

b. Printing should be single spaced. Each paragraph shall be separated by at least one blank line. A standard, 12-point font size applies and the font must be New Times Roman. Tables and illustrations may use a reduced font size no less than 8-point and may be landscape.

c. The following volumes of material shall be submitted:

PRINTED DIGITAL MAXIMUM

VOLUME TITLE COPIES COPIES PAGES

I – Deliverables Original + 4 1 300 II – Cost/Price Original + 4 1 50 III – Past Performance Original + 4 1 300 IV – Representations, Certifications, & Other Statements Original + 4 1 N/A

NOTE: Pages that exceed the required page limitations will not be evaluated. Additional pages over the maximum allowed will be removed or not read and will not be evaluated by the Government.

3. PROPOSAL FILES

a. Format. The submission shall be clearly indexed and logically assembled. Each volume shall be clearly identified and shall begin at the top of a page and all pages of each volume shall be appropriately numbered and identified by the complete company name, date and RFP number in the header and/or footer. A Table of Contents should be created using the Table of Content feature in MS Word. MS Word (doc) files shall use the following page setup parameters:

Margins – Top, Bottom, Left, Right – 1” Gutter – 0” From Edge – Header, Footer 0.5” Page Size, Width – 8.5” Page Size, Height – 11”

NOTE: 11X17 folded pages are acceptable for tables/graphic representations; however, each 11X17 page counts as two pages.

The following additional restrictions apply:

b. File Packaging. The South Carolina Army National Guard currently uses MS Office 2013, all electronic documents must be compatible with this software version and must be restricted by the offeror as READ ONLY.

c. Content Requirement. All information shall be confined to the appropriate file. The offeror shall confine submissions to essential matters, sufficient to define the proposal in a concise manner, to permit a complete and accurate evaluation of each proposal. Each file of the proposal shall consist of a Table of Contents, Summary Section, and the Narrative discussion. The Summary Section shall contain a brief abstract of the file. Proprietary information shall be clearly marked. The following shall be included in the Narrative discussion:

(i) VOLUME I – Deliverables. This volume shall contain those deliverables as outlined in the PWS, Technical Exhibit 2, that are annotated as “Submit with Proposal”. There is a 300 page maximum for this volume.

These documents will be evaluated as the Technical Approach.

(ii) VOLUME II – Cost/Price. This volume shall contain Sections A & B from the Solicitation (SF 1449) (pages 1 thru 16) filled out as applicable. Certified cost and pricing data are not currently required; however, the Government reserves the right to request such data prior to award. Only authorized officials who have the authority to bind their company to contracts may sign this document.

(iii) VOLUME III – Past Performance. This volume shall contain past performance information regarding government or commercial contracts of a similar nature. This volume shall not exceed 100 pages plus five pages for each major subcontractor, excluding Past Performance Questionnaire Forms. Offerors shall submit all Government and/or commercial contracts for the prime offeror and each major subcontractor in performance or awarded during the past three years (governmental or non-governmental of a similar nature), from the issue date of this RFP, which are relevant to the efforts required by this solicitation. Relevant efforts are defined as services/efforts that are the same as or similar to the effort (as compared to NAICS code 621210) required by the RFP. Data concerning the offeror shall be provided first, followed by each proposed major subcontractor, in alphabetical order. The Offeror shall also submit the written consent of its major subcontractors to allow the disclosure of its subcontractor’s past performance information to the Offeror. In addition, letters of commitment shall be included for all major subcontractors for their past performance to be considered. This volume shall be organized into the following sections:

(1) Section 1 – Contract Descriptions. This section shall include the following information in the following format.

(a) Contractor/Subcontractor place of performance, CAGE Code and DUNS Number. If the work was performed as a subcontractor, also provide the name of the prime contractor and Point of Contact (POC) within the prime contractor organization (name, and current address, e-mail address, and telephone and fax numbers).

(b) Government / Non-Government contracting activity, and current address, Procuring Contracting Officer’s name, e-mail address, telephone and fax numbers.

(c) Government’s / Non-Government technical representative/COR and current email address, telephone and fax numbers.

(d) Government / Non-Government contract administration activity and the Administrative Contracting Officer’s name, and current e-mail address, telephone and fax number.

(e) Government / Non-Government contract administration activity’s Pre-Award Monitor’s name, and current e-mail address, telephone and fax numbers.

(f) Contract Number and, in the case of Indefinite Delivery type contracts, GSA contracts, and Blanket Purchase Agreements, include Delivery Order Numbers.

(g) Contract Type (specific type such as Fixed-Price (FP), Cost Reimbursement (CR), Time & Material (T&M), etc.). In the case of Indefinite Delivery contracts, indicate specific type (Requirements, Definite Quantity, and Indefinite Quantity) and secondary contract type (FP, CR, T&M, etc.).

(h) Awarded price/cost.

(i) Final or projected final price/cost.

(j) Original delivery schedule, including dates of start and completion or work.

(k) Final or projected final, delivery schedule, including dates of start and completion of work.

(2) Section 2 – Performance. Offerors shall provide a specific narrative explanation of each contract listed in Section 1, Contract Description, describing the objectives achieved and detailing how the effort is relevant to the requirement of this RFP.

(a) For any contracts that did not/do not meet original PWS performance requirements, provide a brief explanation of the reason(s) for the shortcomings and any corrective action(s) taken to avoid recurrence. The offerors shall list each time the delivery schedule was revised and provide an explanation of why the revision was necessary.

All Requests for Deviation and Requests for Waiver shall be addressed with respect to causes and corrective actions.

The offerors shall also provide copy of any Cure Notices or Show Cause Letters received on each contract listed and a description of any corrective action implemented by the offeror or proposed subcontractor. The offerors shall indicate if any of the contracts listed were terminated and the type and reasons for the termination.

(3) Section 3 – Subcontracts. Offerors shall provide an outline of how the effort required by the RFP will be assigned for performance within the offeror’s corporate entity and among the proposed subcontractors. The information provided for the prime offeror and each proposed major subcontractor must include the entire company name, company address, CAGE Code, DUNS Number and type of work to be performed by citing the applicable Government PWS subparagraph number. This includes all subcontractors who will be providing critical services or whose subcontract is for more than 10% of the total proposed cost/price. This section will further include written consent of major subcontractors to allow the disclosure of their subcontractor’s past performance information to the Offeror. In addition, letters of commitment shall be included for all major subcontractors

(4) Section 4 – New Corporate Entities. New corporate entities may submit data on prior contracts involving its officers and employees. However, in addition to the other requirements in this section, the offeror shall discuss in detail the role performed by such persons in the prior contracts cited. Information should be included in the files described in the sections above. Letters of Commitment shall be included in the proposal for these employees in order to be considered. In the case of an offeror without a record of relevant past performance or for whom information on past performance is not available, the offeror may not be evaluated favorably or unfavorably on past performance and will receive a Neutral rating.

(5) Past Performance Questionnaire. For all contracts identified in Section 1, Contract Descriptions, a Past Performance Questionnaire must be completed and submitted. The offeror shall complete Part I of the Past Performance Questionnaire and e-mail the questionnaire to both the Government and Non-Governmental contracting activity responsible for the past/current contract. The POCs shall be instructed to electronically complete Part II of the questionnaire and e-mail the entire questionnaire to the Contracting Office no later than the proposal due date, to blake.s.cromer.civ@mail.mil and james.o.robinson10.mil@mail.mil. The offeror shall e-mail to the Contracting Officer a list of all the POC’s who were sent a questionnaire. The Government must receive this list no later than the proposal due date. The POC List shall be submitted in Word for Windows Table Format to include the following fields: Solicitation Number; Company Name; Contract Number; Government Agency; POC Last Name, First Name;

POC Title; POC Telephone Number; POC E-mail Address; and Date E-Mail to POC (month/day).

(6) Submissions. Offerors are discouraged from providing points of contact with another contractors’ facility, i.e., in case an offeror (or one of his/her team members) is in a subcontract with another contractor who has submitted a proposal on the same requirement. Offerors shall provide and submit the prime contract number and all Governmental agency points of contact (POC) in lieu of subcontract numbers or prime contract POCs in situations as described above.

(7) Small Business Participation Past Performance. All Offerors shall submit information substantiating the Offerors’ past performance in complying with FAR 52.219-8, “Utilization of Small Business”, maximizing opportunities for U.S. small business subcontractors. Offerors shall also provide a statement indicating whether any negative information has been reported in the past six years concerning the Offerors’ past compliance with FAR 52.219-8. If any such negative information has been reported, the Offeror may submit explanations or comments responding to such negative information. Offerors with no prior contracts containing FAR 52.219-8 shall certify the same.

(v) VOLUME IV – Representations, Certifications & Other Statements. This volume shall contain those required provisions from Section K of the solicitation that the offeror must complete and return with their proposals. Only authorized officials who have the authority to bind their company to contracts may sign these documents.

APPENDIX C

SUBJECT: Offeror Past Performance Assessment in Support of Request for Proposal (RFP) Number W912QG-16-R- 0002 Dental Examinations and Treatment Services

Dear Sir/Ma’am;

The South Carolina Army National Guard is currently conducting a competitive source selection to evaluate offerors on subject RFP. As part of this evaluation, we have requested that the offerors provide information about their past performance on same or similar federal, state or local government or commercial contracts as compared to North American Industry Classification System (NAICS) 621210. You have been identified as the point of contact cited on the enclosure.

Your assessment of their performance is extremely valuable to our evaluation. Please complete the enclosure and return it to the below POC no later than 10 days after receipt of request. Submit your questionnaire email to blake.s.cromer.civ@mail.mil and james.o.robinson10.mil@mail.mil.

Your cooperation is greatly appreciated. Questions may be directed to the undersigned at (803)299-1450 or Mr Blake Cromer at (803)299-1537.

NATIONAL GUARD BUREAU

U.S. PROPERTY AND FISCAL OFFICER, SOUTH CAROLINA

9 NATIONAL GUARD ROAD

COLUMBIA, SOUTH CAROLINA 29201-4763

Sincerely, /s/ LTC James O. Robinson Contracting Officer

PAST PERFORMANCE EVALUATION QUESTIONNAIRE FORM

Contractor:___________________________ Contract No.:___________________________________

Subcontract No. (if applicable):_________________________________

POC:________________________________ Title:_________________________________________ (Name) (E.G. PCO/ACO/TM)

(Agency, Telephone No., E-mail Address & Fax Number)

The following questions pertain to the contractor’s record of past (within the past three years) and current performance.

The information that you provide will be used in the awarding of a federal contract. Therefore, it is important that our information be as factual and accurate as possible. Please provide examples and/or explanations (use additional pages if necessary). The following adjectival ratings shall be used in your response.

Outstanding: 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: 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: Performance does not meet most contractual requirements. Serious problems with contractor performance were experienced for which the corrective actions were ineffective.

PART I. (To be completed by the Offeror)

A. CONTRACT IDENTIFICATION

Contractor/Company Name/Division:

Address:

Program Identification/Title:

Contract Number:

Contract Type:

Prime Contractor Name (if different from the contractor name cited above):

Contract Award Date:

Forecasted or Actual Contract Completion Date:

Nature of the Contractual Effort or Items Purchased:

B. IDENTIFICATION OF OFFEROR’S REPRESENTATIVE

Name:

Title:

Date:

Telephone Number:

Address:

E-mail Address:

PART II. EVALUATION (To be completed by Point of Contact – Respondent)

A. Compliance of Products, Services, Documents, and Related Deliverables to Specification Requirements and Standards of Good Workmanship

Outstanding (Explanation must be provided in Comments field below) Good Acceptable Marginal (Explanation must be provided in Comments field below) Unsatisfactory (Explanation must be provided in Comments field below)

Comments:

B. Effectiveness of Project Management (to include use and control of subcontractors).

Acceptable

C. Timeliness of Performance for Services and Product Deliverables.

Acceptable

D. Effectiveness in Forecasting and Controlling Estimated Costs (Use this Question on Cost Reimbursement Type Contracts Only).

Acceptable

E. Commitment to Customer Satisfaction and Business-like Concern for its Customers’ Interest

Acceptable

F. General Comments. Provide any other relevant performance information.

G. Other Information Sources. Please provide the following information:

Are you aware of other relevant past efforts by this company?

If yes, please provide the name and telephone number of a point of contact:

H. Respondent Identification. Please provide the following information:

Organization:

Name:

Title:

Date:

Telephone Number Address:

E-mail Address:

PART III. RETURN INFORMATION

Please return this completed Questionnaire via e-mail to the Contracting Officer identified in the cover letter.

Thank you for your assistance.

Signature Date

Typed or Printed Name

(End of Summary of Changes)