Attachment_5_Technical_Questionnaire_Form.pdf

PROJECT EXPERIENCE FORM (SIMILAR PROJECTS)

Project Title: Contract Type: _____FFP _____Cost _____ Other (Specify) Delivery Method: ____DB ____DBB ____CMc ____Other

Location:

Period of Performance/Date Completed:

Design Contract Amount (if applicable)

Percentage Complete: D/B Contract Amount $

Total Gross Square Footage

Function on Contract (i.e. Prime or Subcontractor) Owner Contact (Name) Owner Contact (Title) Owner Contact (Address) Owner Contact (Phone) Owner Contact (EMAIL) Summary of Actual Performance Under Scope

12414619R0001 Talladega NF Culvert Replacement

KEY PERSONNEL RESUME FORMAT

Provide information, listed below, on separate sheets showing qualifications of each key personnel individual. NOTE: Resumes shall only be provided for positions identified on the list of key personnel identified in the Solicitation.

(a) Name:

(b) Current Position/Title:

(c) Proposed Assignment on this Project, including specific duties proposed to be performed on this Project while in this proposed role:

(d) No. of Years in Same Assignment as Proposed on the Project__________________________

(e) Name of Your Firm___________________________________________________________

(f) No. of Years: With this Firm__________ With other Firms____________

(g) Education:

Degree(s) earned: _______________________________________________________________ School attended: ________________________________________________________________ Year Degree granted: ____________________________________________________________ Degree field/specialization: ________________________________________________________ Specialized Training: (NICET Level)_______________________________________________

(h) Active Registration, if any:

Type: _______ No.____________, State(s) __________, First Year/ Current Year ______/_____

(i) Describe Your Specific Experience and Qualifications Relevant to this Project:

(j) Up to three (3) relevant project examples:

Project Title: ___________________________________________________________________ Project Location: ________________________________________________________________ Project Dollar Value:_____________________________________________________________ Project Size (SF): _______________________________________________________________ Delivery Method (i.e. D/B, DBB, CMc, etc.): _________________________________________ Position Held: __________________________________________________________________ Duties performed: _______________________________________________________________ Company employed with during Project: _____________________________________________

12414619R0001 Talladega NF Culvert Replacement

Project Title: