**ATTACHMENT TITLE**

**J-1 Department of Labor Wage Determination Number/Area**

**J-2 Deleted**

**J-3 Department of The Treasury Small, HUBZone Small, Small
Disadvantaged, Women-Owned Small, Veteran-Owned Small Business, Service
Disabled Veteran Owned Small Business Concerns, & NISH Organizations
Subcontracting Plan Outline**

**J-4 Present and Past Performance Information**

**J-5 Summary of All Contract Periods by Location**

**J-1: Department of Labor Wage Determination and Area**

  -------------- --------------- -------------- -------------- --------------
  **CCO**        **STATE(S)**    **DOL WD NO.** **REVISION     **DATE**
                                                NO.**          

  Andover        Massachusetts   94-2257        18             8/27/2003

  Atlanta        Georgia         94-2133        23             5/30/2003

  Austin         Texas           94-2503        19             5/30/2003

  Brookhaven     New York        94-2373        22             8/29/2003

  Cincinnati     Indiana,        94-2413        20             6/18/2003
                 Kentucky, Ohio                                

  Fresno         California      94-2045        20             8/26/2003

  Kansas City    Kansas,         94-2307        26             8/29/2003
                 Missouri                                      

  Memphis        Arkansas,       94-2495        24             7/29/2003
                 Kentucky,                                     
                 Mississippi,                                  
                 Tennessee                                     

  Ogden          Utah            94-2531        24             9/30/2003

  Philadelphia   New Jersey,     94-2449        17             6/5/2003
                 Pennsylvania                                  
  -------------- --------------- -------------- -------------- --------------

**Note: Department of Labor Wage Determinations Attached.**

  ---------------------------------------------------------------------------------------------
  ** **        **POSITION       **PP**   **GD**   **TOTAL**   **GS Step **DOL   **DOL JOB
               TITLE**                                        1\        \#**    TITLE**
                                                              (Hourly           
                                                              Rate)**           
  ------------ ---------------- -------- -------- ----------- --------- ------- ---------------
  1            CLERK            GS       03       41          9.18      1117    General Clerk
                                                                                III

  2            CLERK            GS       04       140         10.31     1118    General Clerk
                                                                                IV

  3            CLERK            GS       05       9           11.54     1118    General Clerk
                                                                                IV

  4            CLERK (OA)       GS       05       3           11.54     1118    General Clerk
                                                                                IV

  5            DATA TRANSCRIBER GS       04       1           10.31     1312    Secretary II

  6            FILE CLERK       GS       02       8           8.42      1116    General Clerk
                                                                                II

  7            FILE CLERK       GS       03       556         9.18      1117    General Clerk
                                                                                III

  8            FILE CLERK       GS       04       132         10.31     1118    General Clerk
                                                                                IV

  9            FILES ASST       GS       07       1           14.29     1118    General Clerk
                                                                                IV

  10           FILES SPECIALIST GS       06       1           12.86     1118    General Clerk
                                                                                IV

  11           LABORER          WG       02       14          N/A       21040   Material
                                                                                Handling
                                                                                Laborer

  12           LEAD CLERK       GS       02       1           8.42      1116    General Clerk
                                                                                II

  13           LEAD CLERK       GS       03       1           9.18      1117    General Clerk
                                                                                III

  14           LEAD CLERK       GS       05       17          11.54     1118    General Clerk
                                                                                IV

  15           LEAD CLERK       GS       06       2           12.86     1118    General Clerk
                                                                                IV

  16           LEAD MAIL & FILE GS       04       49          10.31     1118    General Clerk
               CLK                                                              IV

  17           LEAD MAIL & FILE GS       05       29          11.54     1118    General Clerk
               CLK                                                              IV

  18           MAIL & FILE      GS       03       54          9.18      1117    General Clerk
               CLERK                                                            III

  19           MAIL & FILE      GS       04       60          10.31     1118    General Clerk
               CLERK                                                            IV

  20           MAIL & FILE      GS       05       7           11.54     1118    General Clerk
               CLERK                                                            IV

  21           MAIL CLERK       GS       04       14          10.31     1118    General Clerk
                                                                                IV

  22           MGMT/PROG ASST   GS       07       2           14.29     1118    General Clerk
               (OA)                                                             IV

  23           PROGRAM ANALYST  GS       09       1           17.48     N/A     N/A

  24           SECRETARY        GS       05       1           11.54     1312    Secretary II

  25           SECRETARY        GS       06       11          12.86     1313    Secretary III

                                                  1155                           

  **NOTES:**                                                                    

  Federal                                                                       
  hires on                                                                      
  General                                                                       
  Schedule pay                                                                  
  rate                                                                          
  currently                                                                     
  performing                                                                    
  duties                                                                        
  falling                                                                       
  under                                                                         
  Department                                                                    
  of Labor                                                                      
  (DOL)                                                                         
  Directory of                                                                  
  Occupation                                                                    
  wage grade                                                                    
  labor                                                                         
  categories                                                                    
  ---------------------------------------------------------------------------------------------

**J-2: Deleted.**

**J.3 DEPARTMENT OF THE TREASURY SMALL, HUBZone SMALL, SMALL
DISADVANTAGED, WOMEN-OWNED SMALL, VETERAN-OWNED SMALL BUSINESS, SERVICE
DISABLED VETERAN OWNED SMALL BUSINESS CONCERNS, & NISH ORGANIZATIONS
SUBCONTRACTING PLAN OUTLINE**

The following outline meets the minimum requirements of Public Law
95-507 and the Federal Acquisition Regulation (FAR) Subparts 19.7. It is
intended to be a guideline. It is not intended to replace any existing
corporate plan which is more extensive. If assistance is needed to
locate small business sources, contact the Director, Office of Small
Business Programs (202) 622-0530 or the bureau Small Business
Specialist, Jodie Paustian, (202) 283-1199. Please note that the
Department of the Treasury has subcontracting goals of [41]{.underline}%
for small business, [3]{.underline} % for HUBZone small business,
[5]{.underline} % for small disadvantaged business, [5]{.underline} %
for women-owned small business, [3]{.underline} % for Service Disabled
Veteran-Owned small business concerns, and [1]{.underline} % for NISH
organizations for fiscal year [2003]{.underline}. For this procurement,
the Department of the Treasury expects all proposed subcontracting plans
to contain the following goals, at a minimum, for small business
[41]{.underline}%, for HUBZone small business concerns [3]{.underline}
%, for small disadvantaged business concerns [5]{.underline} %, for
women-owned small business concerns [5]{.underline} %, for Service
Disabled Veteran-Owned small business concerns [3]{.underline} %, and
for NISH organizations [1]{.underline} %. Although there is no statutory
goal for Veteran-Owned small business (VOSB) concerns, a VOSB goal must
be proposed in accordance with FAR 19.7 and should represent the
offerors effort to provide the maximum practicable subcontracting
opportunities for VOSBs. These percentages shall be expressed as
percentages of the total available subcontracting dollars.

Identification Data: Company Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date Prepared:\_\_\_\_\_\_\_\_\_\_\_\_\_Solicitation
Number:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Item/Service:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Place of
Performance:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

1\. [TYPE OF PLAN: (Check only one).]{.underline}

INDIVIDUAL PLAN: In this type of plan all elements are developed
specifically for this contract and are applicable for the full term of
this contract.

MASTER PLAN: In this type of plan, goals are developed for this
contract; all other elements are standard. The master plan must be
approved every three (3) years. Once incorporated into a contract with
specific goals, it is valid for the life of the contract.

COMMERCIAL PLAN: This type of plan is used when the contractor sells
products and services customarily used for nongovernmental purposes.
Plan/goals are negotiated with the initial agency on a company-wide
basis rather than for individual contracts. The plan is effective only
during year approved. The contractor must provide a copy of the initial
agency approval, AND MUST SUBMIT AN ANNUAL SF 295 TO TREASURY WITH A
BREAKOUT OF SUBCONTRACTING PRORATED FOR TREASURY (WITH A BUREAU
BREAKDOWN, IF POSSIBLE).

2\. [GOALS:]{.underline}

FAR 19.704(a)(1) requires separate dollar and percentage goals for using
small business concerns, HUBZone small business concerns, small
disadvantaged business concerns, women-owned small business,
veteran-owned small business, and service disabled veteran-owned small
business concerns as subcontractors for the base year and each option
year. (Please note that the goals for HUBZone small business, small
disadvantaged business, women-owned small business, veteran-owned small
business, and service disabled veteran-owned small business concerns are
sub-sets of the small business goal).

A. Estimated dollar value of all planned subcontracting, i.e., to all
types of business concerns under this contract is:

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4TH OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

B. Estimated dollar value\* and percentage of planned subcontract­ing to
small business concerns is:

(\*This figure includes the amount in C., D., E., F., G., and H. below.)

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4TH OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

[%]{.underline} [%]{.underline} [%]{.underline} [%]{.underline}
[%]{.underline}

C. Estimated dollar value and percentage of planned subcontracting to
HUBZone small business concerns is:

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4TH OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

[%]{.underline} [%]{.underline} [%]{.underline} [%]{.underline}
[%]{.underline}

D. Estimated dollar value and percentage of planned subcontract­ing to
small disadvantaged business concerns is:

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4TH OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

[%]{.underline} [%]{.underline} [%]{.underline} [%]{.underline}
[%]{.underline}

E. Estimated dollar value and percentage of planned subcontract­ing to
small women-owned business concerns is:

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4^TH^ OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

[%]{.underline} [%]{.underline} [%]{.underline} [%]{.underline}
[%]{.underline}

F. Estimated dollar value and percentage of planned subcontract­ing to
veteran-owned small business concerns is:

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4TH OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

[%]{.underline} [%]{.underline} [%]{.underline} [%]{.underline}
[%]{.underline}

G. Estimated dollar value and percentage of planned subcontract­ing to
service disabled veteran-owned small business concerns is:

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4TH OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

[%]{.underline} [%]{.underline} [%]{.underline} [%]{.underline}
[%]{.underline}

H. Estimated dollar value and percentage of planned subcontract­ing to
NISH organizations is:

FY FY FY FY FY

[BASE]{.underline} [1ST OPTION]{.underline} [2ND OPTION]{.underline}
[3RD OPTION]{.underline} [4TH OPTION]{.underline}\*\*

[\$]{.underline} [\$]{.underline} [\$]{.underline} [\$]{.underline}
[\$\_\_\_\_\_\_\_\_\_]{.underline}

[%]{.underline} [%]{.underline} [%]{.underline} [%]{.underline}
[%]{.underline}

\*\*IF ANY CONTRACT HAS MORE THAN FOUR OPTIONS, PLEASE ATTACH ADDITIONAL
SHEETS SHOWING DOLLAR AMOUNTS AND PERCENTAGES.

I. Supplies and/or services to be subcontracted under this contract,
business size (i.e., SB, HUBZone, SDB, WOB, VOSB, SDVOSB, and LB), and
the estimated dollar expenditure, are: (Check all that apply).

SUPPLY/ COMPANY BUSINESS DOLLAR

SERVICE NAME SIZE AMOUNT

> (IF KNOWN) (SB, HUBZone,
>
> SDB, WOB,

VOSB, SDVOSB, LB)

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
(Attach additional sheets if necessary.)

J. Explain the methods used to develop the subcontracting goals for
small, HUBZone small business, small disadvantaged, women-owned small
business, veteran-owned small business, and service disabled
veteran-owned small business concerns. Explain how the product and
service areas to be subcontracted were established, how the areas to be
subcon­tracted to small, HUBZone small business, small disadvantaged,
women-owned small, veteran-owned small business, and service disabled
veteran-owned small businesses were determined, and how the capabilities
of small, HUBZone small, small disadvan­taged, women-owned small,
veteran-owned and service disabled veteran-owned small businesses were
deter­mined. Identify all source lists used in the determination process.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

K. Indirect and overhead costs \_\_\_\_\_\_ HAVE BEEN

\_\_\_\_\_\_ HAVE NOT BEEN

> included in the dollar and percentage subcontracting goals stated
> above. (Check one.)

L. If indirect and overhead costs HAVE BEEN included, explain the method
used to determine the proportionate share of such costs to be allocated
as subcontracts to small, HUBZone small, small disadvantaged,
women-owned small, veteran-owned, and service disabled veteran-owned
small business concerns.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. [PLAN ADMINISTRATOR:]{.underline}

FAR 19.704(a)(7) requires information about the company employee who
will administer the subcontracting program. Please provide the name,
title, address, phone number, position within the corporate structure
and the duties of that employee.

[Name:]{.underline}

[Title:]{.underline}

[Address:]{.underline}

[Telephone:]{.underline}

[Fax:]{.underline}

[E:mail Address:]{.underline}

[Position:]{.underline}

[Duties]{.underline}: Does the individual named above perform the
following? (If NO is checked, please indicate who in the company
performs those duties, or indicate why the duties are not performed in
your company).

A. Developing and promoting company/division policy statements that
demonstrate the company\'s/division\'s support for awarding contracts
and subcontracts to small, HUBZone small, small disadvantaged,
women-owned small, veteran-owned, and service disabled veteran-owned
small business concerns.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

B. Developing and maintaining bidders\' lists of small, HUBZone small,
small disadvantaged, women-owned small, veteran-owned small, and service
disabled veteran-owned small business concerns from all possible
sources.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

C. Ensuring periodic rotation of potential subcontractors on bidders\'
lists.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

D. Assuring that small, HUBZone small, small disadvantaged, women-owned
small, veteran-owned small, and service disabled veteran-owned small
businesses are included on the bidders\' list for every subcontract
solicitation for products and services they are capable of providing.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

E. Ensuring that subcontract procurement \"packages\" are designed to
permit the maximum possible participation of small, HUBZone small, small
disadvantaged, women-owned small, veteran-owned small, and service
disabled veteran-owned small businesses.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

F. Reviewing subcontract solicitations to remove statements, clauses,
etc., which might tend to restrict or prohibit small, HUBZone small,
small disadvantaged, women-owned small, veteran-owned small, and service
disabled veteran-owned small business participation.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

G. Ensuring that the subcontract bid proposal review board documents its
reasons for not selecting any low bids submitted by small, HUBZone
small, small disadvantaged, women-owned small, veteran-owned small, and
service disabled veteran-owned small business concerns.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

H. Overseeing the establishment and maintenance of contract and
subcontract award records.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

I. Attending or arranging for the attendance of company counsel­ors at
Business Opportunity Workshops, Minority Business Enterprise Seminars,
Trade Fairs, etc.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

J. Directly or indirectly counseling small, HUBZone small, small
disadvantaged, women-owned small, veteran-owned small, and service
disabled veteran-owned small business concerns on subcontracting
opportuni­ties and how to prepare responsive bids to the company.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

K. Providing notice to subcontractors concerning penalties for
misrepresentations of business status as small, HUBZone small, small
disad­vantaged, women-owned small, veteran-owned small, or service
disabled veteran-owned small business for the purpose of obtaining a
subcontract that is to be included as part or all of a goal contained in
the contractor\'s subcontracting plan.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

L. Conducting or arranging training for purchasing personnel regarding
the intent and impact of Public Law 95-507 on purchasing procedures.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

M. Developing and maintaining an incentive program for buyers which
support the subcontracting program.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

N. Monitoring the company\'s performance and making any adjust­ments
necessary to achieve the subcontract plan goals.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

O. Preparing and submitting timely reports.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

P. Coordinating the company\'s activities during compliance reviews by
Federal agencies.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

4\. [EQUITABLE OPPORTUNITY]{.underline}

FAR 19.704(a)(8) requires a description of the efforts your company will
make to ensure that small, HUBZone small, small disadvantaged,
women-owned small, veteran-owned small, and service disabled
veteran-owned small business concerns will have an equitable opportunity
to compete for subcontracts. (Check all that apply.)

A. Outreach efforts to obtain sources:

> Contacting minority and small business trade associations

Contacting business development organizations

> Attending small and minority business procurement conferences and

trade fairs

> Finding sources from the Small Business Administra­tion\'s
>
> Procurement Network (ProNet)

B. Internal efforts to guide and encourage purchasing personnel:

> Presenting workshops, seminars and training programs
>
> Establishing, maintaining and using small, HUBZone small, small
>
> disad­vantaged, women-owned small, veteran-owned small, and service
> disabled veteran-owned small business source lists, guides and other
> data for soliciting subcontracts
>
> Monitoring activities to evaluate compliance with the
>
> subcontracting plan

C. Additional efforts: (Please describe.)

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

5\. [CLAUSE INCLUSION AND FLOW DOWN]{.underline}

FAR 19.704(a)(9) requires that your company include FAR 52.219-8,
\"Utilization of Small Business Concerns\", in all subcontracts that
offer further subcontracting opportunities. Your company must require
all subcontractors, except small business concerns, that receive
subcontracts in excess of \$500,000 (\$1,000,000 for construction) to
adopt and comply with a plan similar to the plan required by FAR
52.219-9, \"Small Business Subcontracting Plan.\"

Your company agrees that the clause will be included and that the plans
will be reviewed against the minimum requirements for such plans. The
acceptability of percentage goals for small, HUBZone small, small
disadvantaged, women-owned small, veteran-owned small, and service
disabled veteran-owned small business concerns must be determined on a
case-by-case basis depending on the supplies and services involved, the
availability of potential small, HUBZone small, small disadvantaged,
women-owned small, veteran-owned small, and service disabled
veteran-owned small business subcontractors and prior experience. Once
the plans are negotiated, approved, and imple­mented, the plans must be
monitored through the submission of periodic reports, including Standard
Form (SF) 294 and SF 295 reports.

6\. [REPORTING AND COOPERATION]{.underline}

FAR 19.704(a)(10) requires that your company (1) cooperate in any
studies or surveys as may be required, (2) submit periodic reports which
show compliance with the subcontracting plan; (3) submit Standard Form
(SF) 294, \"Subcontracting Report for Individual Contracts,\" and SF
295, \"Summary Subcontract Report,\" in accordance with the instructions
on the forms; and (4) ensure that subcontrac­tors agree to submit SF 294
and SF 295. The cognizant contracting officer of the Treasury bureau
must receive the report(s) within 30 days after the close of each
calendar period. That is:

[Calendar Period]{.underline} [Report Due]{.underline} [Date
Due]{.underline} [Send Report To]{.underline}

10/01\--03/31 SF294 4/30 IRS Contracting

Officer&OSBDU

04/01\--09/30 SF 294 10/30 IRS Contracting

Officer&OSBDU

10/01\--09/30 SF 295 10/30 IRS Contracting

Officer&OSBDU

NOTE: A copy of the 295 report must also be sent to

the Director, Office of Small Business Development,

Department of the Treasury. The address is as follows:

Department of the Treasury

Attn: Director, Office of Small

Business Development

1500 Pennsylvania Avenue, N.W.

Mail Code 655 15^th^/6099

Washington, DC 20220

7\. [RECORDKEEPING]{.underline}

FAR 19.704(a)(11) requires a list of the types of records your company
will maintain to demonstrate the procedures adopted to comply with the
requirements and goals in the subcontracting plan. (Check all that
apply.) (If NO is checked, please indicate why these types of records
are not maintained).

A. Small, HUBZone small, small disadvantaged, women-owned small,
veteran-owned small, and service disabled veteran-owned small business
concern source lists, guides, and other data identifying such vendors.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

B. Organizations contacted for small, HUBZone small, small
disadvantaged, women-owned small, veteran-owned small, and service
disabled veteran-owned small business sources.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

C. On a contract-by-contract basis, records on all subcontract
solicitations over \$100,000 which indicate for each solicita­tion (1)
whether small business concerns were solicited, and if not, why not;
(2)whether HUBZone small business concerns were solicited, and if not,
why not; (3)whether small disadvantaged business concerns were
solicited, and if not, why not; (4) whether women-owned small business
concerns were solicited, and if not, why not; (5) whether veteran-owned
small business concerns were solicited, and if not, why not; (6) whether
service disabled veteran-owned small businesses were solicited, and if
not, why not; and (7) reasons for the failure of solicited small,
HUBZone small, small disadvantaged, women-owned small, veteran-owned
small, and service disabled veteran-owned small business concerns to
receive the subcontract award.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

D. Records to support other outreach efforts, e.g., contacts with
minority and small business trade associations, attendance at small and
minority business procurement conference and trade fairs.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

E. Records to support internal activities to (1) guide and encourage
purchasing personnel, e.g., workshops, seminars, training programs,
incentive awards; and (2) monitor activi­ties to evaluate compliance.

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

F. On a contract-by-contract basis, records to support subcon­tract award
data including the name, address and business size and ownership status
(HUBZone, SDB, WOB, VOSB, SDVOSB, etc.) of each subcontractor. (This
item is not required for company or division-wide commercial plans.)

> \_\_\_\_\_\_\_\_\_\_YES \_\_\_\_\_\_\_\_\_\_NO

G. Other records to support your compliance with the subcontract­ing
plan: (Please describe)

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

8\. [TIMELY PAYMENTS TO SUBCONTRACTORS]{.underline}

FAR 19.702 requires your company to establish and use procedures to
ensure the timely payment of amounts due pursuant to the terms of your
subcontracts with small business concerns, HUBZone small business
concerns, small disadvan­taged business concerns, women-owned small
business concerns, veteran-owned small business concerns, and service
disabled veteran-owned small business concerns.

Your company has established and uses such procedures:

YES NO

9\. [DESCRIPTION OF GOOD FAITH EFFORT]{.underline}

Maximum practicable utilization of small, HUBZone small, small
disadvantaged women-owned small, veteran-owned small, and service
disabled veteran-owned small business concerns as subcontractors in
Government contracts is a matter of national interest with both social
and economic benefits. When a contractor fails to make a good faith
effort to comply with a subcontracting plan, these objectives are not
achieved, and 15 U.S.C. 637(d)(4)(F) directs that liquidated damages
shall be paid by the contractor. In order to demonstrate your compliance
with a good faith effort to achieve the small, HUBZone small, small
disadvantaged, women-owned small, veteran-owned small, and service
disabled veteran-owned small business subcontracting goals, **outline
the steps your company plans to take**. These steps will be negotiated
with the contracting officer prior to approval of the plan.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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10\. [SIGNATURES REQUIRED]{.underline}

This subcontracting plan was SUBMITTED by:

[Signature:]{.underline}

[Typed Name:]{.underline}

[Title:]{.underline}

[Date:]{.underline}

This subcontracting plan was REVIEWED by:

[Signature:]{.underline}

[Typed Name:]{.underline}

[Title: Contracting Officer]{.underline}

[Date:]{.underline}

This subcontracting plan was REVIEWED by:

[Signature:]{.underline}

[Typed Name:]{.underline}

[Title: Small Business Specialist]{.underline}

[Date:]{.underline}

This subcontracting plan was REVIEWED by:

[Signature:]{.underline}

[Typed Name:]{.underline}

[Title: Small Business Administration Representative]{.underline}

[Date:]{.underline}

This subcontracting plan was APPROVED by:

[Signature:]{.underline}

[Typed Name:]{.underline}

[Title: Director, Office of Small Business Programs (or
designee)]{.underline}

[Date:]{.underline}

This subcontracting plan was ACCEPTED by:

[Signature:]{.underline}

[Typed Name:]{.underline}

[Title: Contracting Officer]{.underline}

[Date:]{.underline}

**Section J.4 PRESENT AND PAST PERFORMANCE QUESTIONNAIRE**

**TIRNO-03-R-**

is currently responding to a Department of the Treasury, Internal
Revenue Service for an A-76 Competitive Sourcing Requirement for Files
Activity to provide support services. Present and Past Performance is an
extremely important part of the evaluation for this acquisition, so your
input is very important. Please complete the questionnaire and FAX (202)
283-1290 or e-mail to Charles.J.Conrad@irs.gov. If you have any
questions please call Charles J. Conrad []{.mark}(202) 283-1418.

**PART TWO: GENERAL INFORMATION:**

1\. Was the contractor a ( ) Prime or ( ) Sub-contractor

CONTRACTOR'S NAME AND ADDRESS 2. CUSTOMER ORGANIZATION

3\. CONTRACT NUMBER: 2a. EVALUATOR

4\. CONTRACT VALUE (Circle One): NAME:

\<\$1 million \>\$5 million \>\$20 mil. TITLE:

PHONE NO:

5\. CONTRACT AWARD DATE: 6. CONTRACT COMPLETION DATE:

[/ /]{.underline} [/ /]{.underline}

7\. CONTRACT TYPE (Circle All That Apply): 8. COMPLEXITY OF WORK (Circle
One Response):

FP CPFF CPAF OTHER DIFFICULT or ROUTINE

9\. BRIEF DESCRIPTION OF YOUR CONTRACT REQUIREMENTS:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**PART THREE: OFFEROR PERFORMANCE RATING**

On the following pages, please summarize the offeror's performance in
each rating factors. Each factor has a set of sub factors with four
possible adjectival ratings. Determine the adjectival rating that most
nearly represents your experience with this offeror and indicate your
assessment by placing an "X" under the appropriate heading. Offeror
performance factors are:

A. TECHNICAL CAPABILITY

B. QUALITY OF SERVICES/REPORTS

C. PROJECT MANAGEMENT - RESOURCE ALLOCATION

D. TIMELINESS OF PERFORMANCE

E. COST EFFECTIVENESS

Adjectival ratings are defined below and should be used as a reference
in assessing performance:

PASS: Offeror's performance met or exceeded expectations of all contract
requirements. Minimal potential risk and/or lack of customer
satisfaction anticipated.

FAIL: Offeror's performance did not meet customer expectations of most
contract requirements. Poses significant potential risk and degradation
of performance anticipated.

NEUTRAL: Offeror has no relevant present and past performance available
for evaluation. SP has asserted that it has no directly related or
similar present and past performance experience. Proposal receives no
merit or demerit for this factor.

  ------- --------------------- -------------- -------------- --------------
  **A**   **Technical           **Pass**       **Fail**       **Neutral**
          Capability**                                        

          How would you rate                                  
          the contractor's                                    
          knowledge and                                       
          understanding of                                    
          records management                                  
          services?                                           

  **B**   **Quality of          **Pass**       **Fail**       **Neutral**
          Service**                                           

  1       How would you rate                                  
          the contractor's                                    
          performance in terms                                
          of efficiency,                                      
          accuracy and                                        
          completeness of work?                               

  2       How would you rate                                  
          the accuracy,                                       
          comprehensiveness,                                  
          and clarity of the                                  
          contractor's reports                                
          and documentation?                                  
          Includes SF 294/5                                   
          reports.                                            

  **C**   **Project             **Pass**       **Fail**       **Neutral**
          Management**                                        

  1       How would you rate                                  
          the contractor's                                    
          preparedness to begin                               
          work on the effective                               
          date of the contract?                               

  2       How would you rate                                  
          the contractor's                                    
          management under this                               
          contract?                                           

  3       How would you rate                                  
          the contractor's                                    
          overall project                                     
          management?                                         

  4       How would you rate                                  
          the contractor's                                    
          performance in                                      
          identifying and                                     
          resolving contract                                  
          performance problems                                
          without guidance from                               
          the customer?                                       

  5       How would you rate                                  
          the effectiveness of                                
          the contractor's                                    
          quality control                                     
          procedures?                                         

  6       How would you rate                                  
          the effectiveness of                                
          contractor employee                                 
          training under this                                 
          contract                                            

  7       How would you rate                                  
          the contractor's                                    
          ability to hire                                     
          qualified individuals                               
          and retain a                                        
          qualified and stable                                
          workforce?                                          

  8       How would you rate                                  
          the contractor's                                    
          ability to hire                                     
          replacement personnel                               
          in a timely manner?                                 

  9       How effective was the                               
          contractor in                                       
          understanding and                                   
          responding to user                                  
          requirements                                        

  **D**   **Timeliness of       **Pass**       **Fail**       **Neutral**
          Performance**                                       

          How would you rate                                  
          the contractor's                                    
          performance in                                      
          meeting timeliness                                  
          requirements?                                       

  **E**   **Cost                **Pass**       **Fail**       **Neutral**
          Effectiveness**                                     

          How would you rate                                  
          the contractor's                                    
          performance in                                      
          meeting the cost                                    
          estimate?                                           
  ------- --------------------- -------------- -------------- --------------

**PART THREE: OFFEROR PERFORMANCE RATING CONTINUED**

1\. Has this contract been partially or completely terminated for
default or convenience?

YES Default Convenience

NO

If yes, please explain (e.g. inability to meet cost, performance, or
delivery schedules - also include contract number, name, address, and
phone number of Terminating Contracting Officer - TCO).

2\. What was the contractor's greatest strength in the performance of
the contract?

3\. What was the contractor's greatest weakness in the performance of
the contract?

4\. Would you award another contract to this contractor?

YES No

COMMENTS:

**PART FOUR: EVALUATOR'S CERTIFICATION**

I HEREBY CERTIFY THAT THE INFORMATION IN THIS FORM IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.

SIGNATURE OF EVALUATOR

TITLE OF EVALUATOR DATE

Mr. Conrad:

We are currently participating as a (subcontractor / teaming partner)
with (offeror) in responding to Department of the Treasury, Internal
Revenue Service Request for Proposal TIRNO-04-R-00009 for Files Activity
services under A-76 study.

We understand that the Government is placing increased emphasis on
present and past performance in order to obtain best value in source
selections. In order to facilitate the performance confidence assessment
process, we are signing this consent form in order to allow you to
discuss our present and past performance information with the prime
contractor during the source selection process.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(Signature and Title of individual who has the authority to sign for and
legally bind the company)

Company Name:

Address:

DUNS:

Phone Number and Fax Number:

**[Sample:]{.underline}** Cover Letter for Present and Past Performance
References

Dear (Client):

We are currently responding to the Department of the Treasury, Internal
Revenue Service Request For Proposal TIRNO-04-R- 00009 for the
procurement of Files Activity services under an A-76 Study.

As you know, an offeror's present/past performance has become an element
of increased emphasis in Federal Government acquisitions. The Government
is requesting that clients of companies who submit proposals in response
to this RFP be contacted, and that clients provide performance
information based on their experiences with the offeror. We, therefore,
respectfully request and hereby authorize you to complete the attached
Questionnaire with regards to work we have performed for you,
specifically under contract number (fill-in). Forward the completed
questionnaire directly to the Government Point of Contact at the
following address with the note as indicated:

Internal Revenue Service

Competitive Sourcing Acquisitions

> ATTN: Charles J. Conrad II

6009 Oxon Hill Rd,

Oxon Hill MD 20745

Reference: Present/Past Performance Evaluation

**NOTE**: TO BE OPENED BY ADDRESSEE ONLY SOURCE SELECTION INFORMATION --
See FAR 2.102 and 3.104 FOR OFFICIAL USE ONLY

The Government must receive this Questionnaire no later than September
30, 2004 at 3:00 P. M. EST. []{.mark}

We have identified Mr./Ms. (Name) and/or Mr./Ms. (Name) of your
organization as the points of contact based on their knowledge
concerning our work. While we will be given an opportunity to reply to
any negative information reported, the Government will not reveal the
name of the person who completed the Questionnaire. Your cooperation in
this matter is appreciated. Any questions may be directed to the
following Government official: Charles J. Conrad, II (202) 283-1418.

> Sincerely,
>
> \[OFFEROR\'S POINT OF CONTACT\]

Attachments:

1.  Present/Past Performance Verification / Fact Finding Questionnaire