C--436-113 Construct Primary Care Mental Health Integration
Department of Veterans Affairs, VA Rocky Mountain Consolidated Contracting Center | Published February 8, 2016 - Deadline March 10, 2016
DESCRIPTION: This is a Pre-Solicitation Notice for the establishment of an Architect-Engineering (A-E) contract with services to be performed at the VA Medical Center at Fort Harrison VAMC 3687 Veterans Drive Fort Harrison, MT 59636. This requirement is being set-aside to Small Disabled Veteran Owned Small Business (SDVOSB) firms. THIS ANNOUNCEMENT IS NOT A REQUEST FOR PROPOSAL; NO SOLICITATION PACKAGE WILL BE ISSUED UNTIL AFTER AN EVALUATION HAS BEEN MADE ON THE PROVIDED SF-330s. The SF-330 can be downloaded through the GSA Forms Library at: http://www.gsa.gov/portal/forms/type/TOP, scroll down to locate and click on the SF-330 hyperlink entitled, "Architect-Engineer Qualifications." Written questions pertaining to this requirement should be submitted no later than 2:00 PM. Mountain Standard Time (MST), February 16, 2016. Interested firms should submit their current SF-330, Parts I and II, to Josiah.Benton@va.gov. The SF-330s are due no later than 2:00 PM, MST, March 10, 2016.
SCOPE OF WORK: This contract will provide design services allowing for the construction of a Primary Care facility to VA Directives at the Fort Harrison MT VA Medical Center. The contractor shall design the following
1. This project will construct a 18,400 SF connected facility housing Primary Care in support of the Patient Aligned Care Team (PACT) model of care. It will provide space for examination, treatment, patient education, staff education, group counseling/social activities, staff work areas, and common spaces. The project will also require a level of renovation to existing areas of approximately 2,000 SF needed to facilitate an adequate connection to adjacent functions. Beyond the zero line of the new construction, approximately one acre of space will be subject to site development work encompassing all aspects necessary to accommodate new construction in a previously extensively developed location. Design is also to accommodate a specified area providing for the utilization of a mobile trailer supporting health care operations.
2. The required disciplines to successfully complete this project include Architecture as well as Civil, Structural, Electrical, Mechanical, and Fire Protection Engineering. All design work in these disciplines is to be completed by the A/E firm.
3. Design of the above documented project scope must meet all applicable codes, regulations, and standards. This includes but is not limited to NFPA Codes, NEC, EPA (specifically conduction of NEPA), MT DEQ Regulations, OSHA 1926, ASTM and TJC Standards. Additionally, the A/E is required to meet all applicable laws and regulation not explicitly stated in this document. Design efforts and products shall be conducted and produced in compliance with VA Publications including Master Construction Specifications, Design Guides, and CAD Standards (http://www.cfm.va.gov/TIL). Due to the nature of this project, special attention is to be paid to the requirements as represented in the following documents:
a. PACT Design Guide (http://www.cfm.va.gov/til/dGuide/dgPACT.pdf) This project must conform to the general principles of spatial layout as delineated in the PACT design guide to be considered acceptable.
b. Seismic Design Guide (http://www.cfm.va.gov/TIL/seismic.asp) Due to the location of this construction, certification of compliance to the requirements as indicated in H-18-8 will be required.
c. Physical Security Design Manual (http://www.cfm.va.gov/til/PhysicalSecurity/dmPhySecLS-2007.pdf ***Updates to this document have been published) This project will incorporate a significant amount of building façade as well as side development. As such, certification of the meeting these requirements by an appropriately qualified technical professional will be required.
d. Sustainability Design Guide (http://www.cfm.va.gov/til/sustain.asp) This project is required to comply with public law that requires energy performance exceeding standards specified in ASHRAE 90.1. Compliance is required and must be validated through Energy Modeling.
OFFERORS WILL BE EVALUATED ON THE FOLLOWING CRITERIA:
The submitted SF330s will be evaluated on the following criteria:
This acquisition will be in accordance with FAR Part 36.602-1 and VAAR Part 836.601-1. The following evaluation criteria will be used to evaluate SF 330 technical proposals:
(8) Are the least important and listed in descending order of importance. Specific evaluation criteria include:
1. Specialized experience and technical competence in the type of work required, including, where appropriate, experience in energy conservation, pollution prevention, waste reduction, and the use of recovered materials.
2. Professional Qualifications necessary for satisfactory performance of required services.
3. Capacity to accomplish the work in the required time.
4. Past Performance on contracts with Government agencies and private industry in terms of cost control, quality of work, and compliance with performance schedules.
5. Specific experience and qualifications of personnel proposed for assignment to the project and their record of working together as a team.
6. Location in the general geographical area of the project and knowledge of the locality of the project; provided, that application of this criterion leaves an appropriate number of qualified firms, given the nature and size of the project.
7. Reputation and standing of the firm and its principal officials with respect to professional performance, general management, and cooperativeness.
8. Record of significant claims against the firm because of improper or incomplete architectural and engineering services.
Criterion 1 - Specialized experience and technical competence in the type of work required, including, where appropriate, experience in energy conservation, pollution prevention, waste reduction, and the use of recovered materials. Offerors will be evaluated on specialized experience and technical competence in the performance of services similar to those anticipated under this contract with regard to:
o Experience with design of similar types of facilities; with preference given to Outpatient Ambulatory Care clinical space
o Experience designing projects required to be constructed during continuous operation of the existing asset that were subject to a constructability review to eliminate conflicts.
o Experience with designing s additions to an existing facility that accommodate both the newly constructed area as well as renovation of existing adjacent space to support continuity of the space.
o Experience in providing post construction award services (shop drawing review, RFI's, As-built drawings, Quality Assurance Plan (QAP) review, construction inspection services, and investigative site visits to address any necessary redesign requirements).
Submission requirements: Provide up to five (5) projects completed or substantially completed within the past five (5) years that best illustrate specialized experience of the proposed team in the areas outlined above. Example projects shall note project's square footage. All projects provided in the SF 330 must be completed by the office/branch/regional office/individual team member actually proposed to manage and/or perform work under this contract. To enable verification, firms should include the DUNS number along with each firm name in the SF 330 Part 1, Section F Item 25 "Firms from Section C Involved in this Project," block (1). Include a contract number or project identification number in block 21. Include an e-mail address, and phone number for the point of contact in block 23(c). Include in the project description the contract period of performance, award contract value, current contract value, a summary of the work performed that demonstrates relevance to specialized experience as outlined above. If the contractor served as a subcontractor on a project, indicate the value of the work they provided towards the performance of the overall project. If a project was performed by a joint venture, and not all joint venture partners are on the team proposed for this contract, the offeror/team should specifically address the work performed by the joint venture partner offering/teaming on this contract. Likewise, if the offeror/team member worked as a subcontractor on a project, the description should clearly describe the work actually performed by the offeror/team member and the roles and responsibilities of each on the project, rather than the work performed on the project as a whole. If the project description does not clearly delineate the work performed by the entity/entities offering/teaming on this contract, the project could be eliminated from consideration.
NOTE: If the Offeror is a joint venture, information should be submitted as a joint venture; however, if there is no information for the joint venture, information should be submitted for either joint venture partner, not to exceed a total of five (5) projects for this criterion. Projects shall be submitted on the SF330. For submittal purposes, a task order on an IDIQ contract is considered a project, as is a stand-alone contract award. Do not list an IDIQ contract as an example of a completed project. Instead, list relevant completed task orders or stand-alone contract awards that fit within the definition above. Examples of project work submitted that do not conform to this requirement will not be evaluated.
Failure to provide requested data, accessible points of contact, or valid phone numbers could result in a firm being rated lower.
All information for Criterion 1 should be submitted in Part 1, Section F of the SF330. The Government WILL NOT consider information submitted in addition to Part 1, Section F in evaluating Criterion 1.
Criterion 2 - Professional Qualifications necessary for satisfactory performance of required services. Offerors will be evaluated in terms of the qualifications, competence and experience of the key personnel and technical team proposed to accomplish this work. Key personnel are individuals who will have major contract or project management responsibilities and/or will provide unusual or unique expertise. Provide a balanced licensed and or certified workforce in the following disciplines - Architecture, Civil, Structural, Mechanical, Electrical, and Fire Protection Engineering. Qualifications in the areas of Environmental Engineering, LEED-AP, Interior Design, Project Planning and Management, American Society for Industrial Security (CPP or PSP).
Submission requirements: Provide resumes for all proposed key personnel. Resumes are limited to one page each and should cite project specific experience and indicate proposed role in this contract. Provide professional registration, certification, licensure and/or accreditation. Indicate participation of key personnel in example projects in the SF 330 Part 1 Section G.
Criterion 3 - Capacity to accomplish the work in the required time. Firms/teams will be evaluated in terms of their ability to plan for and manage work under the contract and capacity to accomplish the work in the required time.
Submission requirements: Describe the firm's ability to concurrently perform and manage multiple projects in different locations to meet aggressive schedules, multiple disciplines, and control costs and the firm's capacity to accomplish multiple projects simultaneously.
Criterion 4 - Past Performance - Offerors will be evaluated on past performance with Government agencies and private industry in terms of work quality, compliance with schedules, cost control, and stakeholder/customer satisfaction. Evaluating past performance and experience will include information provided in Past Performance Questionnaires (PPQs) or CPARS/ACASS for Criterion 1 projects and may include other information provided by the firm, customer inquiries, Government databases, and other information available to the Government including contacts with points of contact in other criteria. Failure to provide requested data, accessible points of contact, or valid phone numbers could result in a firm being rated lower.
Submission requirements: SUBMIT A COMPLETED CPARS/ACASS EVALUATION FOR EACH PROJECT UNDER CRITERION 1. IF THERE IS NOT A COMPLETED CPARS/ACASS EVALUATION, the Past Performance Questionnaire (PPQ) (Attachment (A)) included in this notice is provided for the offeror or its team members to submit to the client for each project the offeror includes under Criterion 1. AN OFFEROR SHALL NOT SUBMIT A PPQ WHEN A COMPLETED CPARS/ACASS IS AVAILABLE. IF A CPARS/ACASS EVALUATION IS NOT AVAILABLE, ensure correct phone numbers and email addresses are provided for the client point of contact. Completed PPQs should be submitted with your SF 330. If the offeror is unable to obtain a completed PPQ from a client for a project(s) before the response date set forth in this notice, offerors should complete and submit with their responses the first page of the PPQ (Attachment), which will provide contract and client information for the respective project(s). Offerors may submit a PPQ previously submitted under a different Notice/RFP (legible copies are acceptable) as long as it is on the same form as posted with this Synopsis. Offerors should follow up with clients/references to ensure timely submittal of questionnaires. If requested by the client, questionnaires may be submitted directly to the Government's point of contact, Network Contracting Office 19, Attn: Josiah Benton via email at Josiah.firstname.lastname@example.org prior to the response date. Offerors shall not incorporate by reference into their response PPQs or CPARS previously submitted in response to other A/E services procurements. However, this does not preclude the Government from utilizing previously submitted PPQ information in the past performance evaluation.
Criterion 5 - Specific experience and qualifications of personnel proposed for assignment to the project and their record of working together as a team.
Submission requirements: Offerors shall submit evidence of individuals experience and qualifications in their respective fields. Additionally, documentation must be provided to show these individuals have worked together as a team on previous projects and their role. (Completing Sections E, F, and G, on the SF330 meets the documentation requirement). Furthermore, offerors shall describe the ability of the firm to manage, coordinate and work effectively with team members, both internal staff and consultants. Discuss the history of working relationships with team members, including joint venture partners where applicable.
Criterion 6 - Location in the general geographical area (Fort Harrison, MT) and knowledge of the (Fort Harrison, MT); provided, that application of this criterion leaves an appropriate number of qualified firms, given the nature and size of the project. Provided that the application of this criterion leaves an appropriate number of qualified firms, given the nature and size of the contract, firms/teams will be evaluated on the locations of their office or offices that will be performing the work under this contract.
Submission requirements: Indicate firms/teams location, including main offices, branch offices and any subconsultants' offices and demonstrate how this will be advantageous to the Government.
Criterion 7 - Reputation and standing of the firm and its principal officials with respect to professional performance, general management, and cooperativeness.
Submission requirements: Offerors shall provide documentation (awards, certificates, publications, commendations from within the community) as evidence of reputation and standing of its firm.
Criterion 8 - Record of significant claims against the firm because of improper or incomplete architectural and engineering services. Offerors with substantiated claims against the firm as a result of improper architectural and engineering services provided in the last three (3) years.
Submission requirements: Records and any other documentation of substantiated claims highlighting improper or incomplete architectural engineering services against the firm within the last three (3) years. The SF 330 shall contain a signed and dated statement by the president of the firm affirming that there are no records of significant claims because of improper or incomplete architectural and engineering services.
Interviews shall be scheduled with firms slated as the most highly qualified. Firms slated for interviews may be asked to explain or expand on information contained in the SF330 submittal. Elaborate presentations are not desired.
Requirement for Electronic Submission
Unless paper offers are specifically authorized, all responses to this pre-solicitation notice must be submitted electronically as described below. The only acceptable paper form for this requirement is the receipt of past performance questionnaires. Failure to comply with this requirement may jeopardize the possibility of receiving an award for the contract due to non-compliance with the terms of the solicitation. You must submit your electronic offer, and any supplemental information (such as spreadsheets, backup data, technical information), using any of the electronic formats and media described below.
In addition, contractors are notified of the award via an electronic Notice of Award e-mail. The award document will be attached to the Notice of Award e-mail.
Acceptable Electronic Formats (Software) for Submission of Offers
1. Files readable using the current Microsoft* Office version Products: Word, Excel, PowerPoint, or Access. Spreadsheet documents must be sent in a format that includes all formulas, macro, and format information. Print or scan images of spreadsheets are not acceptable. Please see security note below for caution regarding use of macros. When submitting construction drawings contractors are required to submit one set in AutoCAD and one set in Adobe PDF. (Purpose: contracting can open the PDF version and engineering can open AutoCAD files)
2. Files in Adobe* PDF (Portable Document Format) Files: When scanning documents scanner resolution should be set to 200 dots per inch, or greater.
3. Other electronic format. If you wish to submit an offer using another format than those described in these instructions, e-mail the Contracting Officer who issued the solicitation. Please submit your request at least ten (10) calendar days before the scheduled closing date of the solicitation. Request a decision as to the format acceptability and make sure you receive approval of the alternate format before using it to send your offer.
4. Please note that we can no longer accept .zip files due to increasing security concerns.
E-mail Submission Procedures: For simplicity in this guidance, all submissions in response to a solicitation will be referred to as offers.
a. Subject Line: Include the solicitation number, name of company, and closing date of solicitation. Use only one of the terms Quotation, Offer, or Bid depending on the solicitation type.
b. Size: Maximum size of the e-mail message shall not exceed five (5) megabytes and the SF330 will not exceed fifty (50) pages. Only one email is permitted unless otherwise stated in this solicitation or in writing by the Contract Officer submitting the solicitation.
c. Unless approved by the contracting officer: DO NOT submit a link to your PDF documents. Please submit your request in an email for other electronic format at least ten (10) calendar days before the scheduled closing date of the solicitation. Request a decision as to the format acceptability and ensure you receive approval of the alternate format before using it to send your offer.
The offer will be date and time stamped by the Microsoft Email system and will be the official record of receipt for the submission.
Security Issues, Late Bids, Unreadable Offers
1. Late submission of offers are outlined at FAR Parts 52.212-1(f), 52.214-7, and 52.215-1(c)(3). Particular attention is warranted to the portion of the provision that relates to the timing of submission.
2. Please see FAR 15.207(c) for a description of the steps the Government shall take with regard to unreadable offers.
3. To avoid rejection of an offer, vendors must make every effort to ensure their electronic submission is virus-free. Submissions or portions thereof submitted and which the automatic system detects the presence of a virus or which are otherwise unreadable will be treated as "unreadable" pursuant to FAR Parts 14.406 and FAR 15.207(c ).
4. The virus scanning software used by our e-mail systems cannot always distinguish a macro from a virus. Therefore, sending a macro embedded in an e-mail message or an e-mail attachment may cause the e-mail offer to be quarantined. You may send both the spreadsheet and the spreadsheet saved in PDF format to ensure that your proposal is readable.
5. Password protecting your offer is not permitted. The Contracting Officer will file the offer electronically which will allow access only by designated individuals.
Important Notice: Apparent successful offerors must apply for and receive verification from the Department of Veterans Affairs Center for Verification and Evaluation (CVE) in accordance with 38 CFR Part 74 and VAAR 819.70 by submission of documentation of Veteran status, ownership and control sufficient to establish appropriate status, offerors must be both VISIBLE and VERIFIED by the Department of Veteran Affairs Center for Verification and Evaluation prior to contract award. Failure to be both VERIFIED by CVE and VISIBLE on VetBiz prior to contract award will result in the offeror's proposal being deemed non-responsive. All offerors are urged to contact the CVE and submit the aforementioned required documents to obtain CVE verification of their SDVOSB status if they have not already done so.
852.219-10 VA NOTICE OF TOTAL SERVICE-DISABLED VETERAN-OWNED
SMALL BUSINESS SET-ASIDE (DEC 2009)
(a) Definition. For the Department of Veterans Affairs, "Service-disabled veteran-owned small business concern":
(1) Means a small business concern:
(i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans (or eligible surviving spouses);
(ii) The management and daily business operations of which are controlled by one or more service-disabled veterans (or eligible surviving spouses) or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran;
(iii) The business meets Federal small business size standards for the applicable North American Industry Classification System (NAICS) code identified in the solicitation document; and
(iv) The business has been verified for ownership and control and is so listed in the Vendor Information Pages database, (http://www.VetBiz.gov).
(2) "Service-disabled veteran" means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).
(b) General. (1) Offers are solicited only from service-disabled veteran-owned small business concerns. Offers received from concerns that are not service-disabled veteran-owned small business concerns shall not be considered.
(2) Any award resulting from this solicitation shall be made to a service-disabled veteran-owned small business concern.
(c) Agreement. A service-disabled veteran owned small business concern agrees that in the performance of the contract, in the case of a contract for:
(1) Services (except construction), at least 50 percent of the cost of personnel for contract performance will be spent for employees of the concern or employees of other eligible service-disabled veteran-owned small business concerns;
(2) Supplies (other than acquisition from a non-manufacturer of the supplies), at least 50 percent of the cost of manufacturing, excluding the cost of materials, will be performed by the concern or other eligible service-disabled veteran-owned small business concerns;
(3) General construction, at least 15 percent of the cost of the contract performance incurred for personnel will be spent on the concern's employees or the employees of other eligible service-disabled veteran-owned small business concerns; or
(4) Construction by special trade contractors, at least 25 percent of the cost of the contract performance incurred for personnel will be spent on the concern's employees or the employees of other eligible service-disabled veteran-owned small business concerns.
(d) A joint venture may be considered a service-disabled veteran owned small business concern if-
(1) At least one member of the joint venture is a service-disabled veteran-owned small business concern, and makes the following representations: That it is a service-disabled veteran-owned small business concern, and that it is a small business concern under the North American Industry Classification Systems (NAICS) code assigned to the procurement;
(2) Each other concern is small under the size standard corresponding to the NAICS code assigned to the procurement; and
(3) The joint venture meets the requirements of paragraph 7 of the explanation of Affiliates in 19.101 of the Federal Acquisition Regulation.
(4) The joint venture meets the requirements of 13 CFR 125.15(b).
(e) Any service-disabled veteran-owned small business concern (non-manufacturer) must meet the requirements in 19.102(f) of the Federal Acquisition Regulation to receive a benefit under this program.
PAST PERFORMANCE QUESTIONNAIRE
Solicitation Number: Project Title:
CONTRACT INFORMATION (Contractor to complete Blocks 1-4)
1. Contractor Information
Firm Name: CAGE Code:
Address: DUNs Number:
Phone Number: Email Address:
Point of Contact: Contact Phone Number:
2. Work Performed as: 0 Prime Contractor 0 Sub Contractor 0 Joint Venture 0 Other
Percent of project work performed:
If subcontractor, who was the prime (Name/Phone #):
3. Contract Information
Contract Number: Delivery/Task Order Number (if applicable):
Contract Type: 0 Firm Fixed Price 0 Cost Reimbursement 0 Other (Please specify):
Contract Title: Contract Location:
Award Date (mm/dd/yy):
Contract Completion Date (mm/dd/yy):
Actual Completion Date (mm/dd/yy):
Original Contract Price (Award Amount):
Final Contract Price (to include all modifications, if applicable):
4. Project Description:
Complexity of Work 0 High 0 Med 0 Routine
How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)
CLIENT INFORMATION (Client to complete Blocks 5-8)
5. Client Information
Phone Number: Email Address:
6. Describe the client's role in the project:
7. Date Questionnaire was completed (mm/dd/yy):
8. Client's Signature:
E VG S M U N
(Outstanding) Very Good
(Above Average) Satisfactory Marginal Unsatisfactory Not Available
Performance meets contractual requirements and exceeds many to the Government's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with few minor problems for which corrective actions taken by the Contractor were highly effective
Performance meets contractual requirements and exceeds some to the Government's benefit. The contractual performance of the element or sub-element being evaluated was accomplished with some minor problems for which corrective actions taken by the Contractor were effective
Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the Contractor appear, or were, satisfactory. Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being evaluated reflects a serious problem for which the Contractor has not yet identified corrective actions. The Contractor's proposed actions appear only marginally effective, or were not fully implemented
Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains a serious problem(s) for which the Contractor's corrective actions appear or were ineffective
No record of past performance or the record is inconclusive.
a) Quality of technical data/report preparation efforts E VG S M U N
b) Ability to meet quality standards specified for technical performance E VG S M U N
c) Timeliness/effectiveness of contract problem resolution without extensive customer guidance E VG S M U N
d) Adequacy/effectiveness of quality control program and adherence to contract quality assurance requirements (without adverse effect on performance) E VG S M U N
2. SCHEDULE/TIMELINESS OF PERFORMANCE:
a) Compliance with contract delivery/completion schedules including any significant intermediate milestones. (If liquidated damages were assessed or the schedule was not met, please address below) E VG S M U N
b) Rate the contractor's use of available resources to accomplish tasks identified in the contract E VG S M U N
3. CUSTOMER SATISFACTION:
a) To what extent were the end users satisfied with the project? E VG S M U N
3. a.1. Comments:
b) Contractor was reasonable and cooperative in dealing with your staff (including the ability to successfully resolve disagreements/disputes; responsiveness to administrative reports, businesslike and communication) E VG S M U N
c) To what extent was the contractor cooperative, businesslike, and concerned with the interests of the customer? E VG S M U N
d) Overall customer satisfaction E VG S M U N
4. MANAGEMENT/ PERSONNEL/LABOR
a) Effectiveness of on-site management, including management of subcontractors, suppliers, materials, and/or labor force? E VG S M U N
b) Ability to hire, apply, and retain a qualified workforce to this effort E VG S M U N
c) Government Property Control E VG S M U N
d) Knowledge/expertise demonstrated by contractor personnel E VG S M U N
e) Utilization of Small Business concerns E VG S M U N
f) Ability to simultaneously manage multiple projects with multiple disciplines E VG S M U N
g) Ability to assimilate and incorporate changes in requirements and/or priority, including planning, execution and response to Government changes E VG S M U N
h) Effectiveness of overall management (including ability to effectively lead, manage and control the program) E VG S M U N
5. COST/FINANCIAL MANAGEMENT
a) Ability to meet the terms and conditions within the contractually agreed price(s)? E VG S M U N
b) Contractor proposed innovative alternative methods/processes that reduced cost, improved maintainability or other factors that benefited the client E VG S M U N
c) If this is/was a Government cost type contract, please rate the Contractor's timeliness and accuracy in submitting monthly invoices with appropriate back-up documentation, monthly status reports/budget variance reports, compliance with established budgets and avoidance of significant and/or unexplained variances (under runs or overruns) E VG S M U N
d) Is the Contractor's accounting system adequate for management and tracking of costs? If no, please explain in Remarks section. Yes No
e) If this is/was a Government contract, has/was this contract been partially or completely terminated for default or convenience or are there any pending terminations? Indicate if show cause or cure notices were issued, or any default action in comment section below. Yes No
f) Have there been any indications that the contractor has had any financial problems? If yes, please explain below. Yes No
a) To what extent was the contractor able to maintain an environment of safety, adhere to its approved safety plan, and respond to safety issues? (Includes: following the users rules, regulations, and requirements regarding housekeeping, safety, correction of noted deficiencies, etc.) E VG S M U N
b) Contractor complied with all security requirements for the project and personnel security requirements. E VG S M U N
a) Ability to successfully respond to emergency and/or surge situations (including notifying COR, PM or Contracting Officer in a timely manner regarding urgent contractual issues). E VG S M U N
b) Compliance with contractual terms/provisions (explain if specific issues) E VG S M U N
c) Would you hire or work with this firm again? (If no, please explain below) Yes No
d) In summary, provide an overall rating for the work performed by this contractor. E VG S M U N
Please provide responses to the questions above (if applicable) and/or additional remarks. Furthermore, please provide a brief narrative addressing specific strengths, weaknesses, deficiencies, or other comments which may assist our office in evaluating performance risk (please attach additional pages if necessary):
Past Performance Information provided by: __________________________________________________
Signature: ________________________________________ Date: ____________________________
Organization: _____________________________________ Phone: ____________________________