EXHIBIT_C_-_Reference_Questionnaire_package.pdf

W91SMC-17-R-0004

126th Repair Squadron Operations Facility, Project Number: VDYD132014

EXHIBIT C PACKAGE INFORMATION AND FORMS

EXHIBIT C PACKAGE INFORMATION AND FORMS - A “Final” Construction Performance Evaluation that is created in CPARS and reported in PPIRS that is issued for a project may be included in lieu of sending out reference package for the project.

Place the CPARS 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.

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 Massachusetts USPFO 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 26 JUN 2017 Do not return them to our company.

182 Airlift Wing/Base Contracting ATTN: SMSgt Melissa Grice 2416 S. Falcon Blvd.

Peoria, IL 61607

Email: Melissa.j.grice.mil@mail.mil

If you have questions regarding the attached questionnaire, or require assistance, please contact SMSgt Melissa Grice via phone at:

(309)633-5204 or email to: Melissa.j.grice.mil@mail.mil Thank you for your assistance. EMAIL IS PREFERRED.

Signature and Title

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

THE

QUESTION

NAIRE

SHOULD

BE

SUBMITTE

D BY THE

FOLLOWIN

G MEANS:

Return via email to the email address shown above.

Mark cover sheet: (Attention: RFP W91SMC-17-R-0004 “Source Selection Sensitive Information”)

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.

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.

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

Outstan ding Good Accept able Margin al

Unsatis factory

Not Appli cable

(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

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

Correction of Noted Deficiencies Payrolls Properly Completed and Submitted

Comments on Compliance With Federal Laws and regulations including Construction Wage Requirements, payrolls, compliance with Drug Free Work Place requirements; Compliance with Executive Order 16393 –Planning for Federal Sustainability in the Next Decade.

COMPLIANCE WITH SAFETY STANDARDS

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:

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:_______________

OFFEROR NAME ________________________________