Attch_04_-_Experience_Information_Sheet.pdf

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Attached to
Arcata Water and Fire Pump Federal contract opportunity
Solicitation number
129AD619Q0007
Issued by
Department of Agriculture Forest Service Research Service Pacific Northwest Research Station

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Attch 04 - Experience Questionnaire

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129AD619Q0007 Attachment 04

EXPERIENCE INFORMATION

SHEET

(Adjust formatting as needed without changing the font, limited to two pages per contract.)

1. Contract/Subcontract No.: _________________________

2. Project Name & current POC information (name/job title/phone#/e-mail):

3. Location work was performed: __________________________________

4. Date work was completed (must be within last 5 years): ______________

a. If work is still ongoing, date work was 50% completed: _____________

5. Final cost of this project: $_______________

6. Clearly describe what part of the work was performed by the firm for which the experience information is submitted. Provide dollar magnitude for each of the following categories if multiple categories are selected.

a. Associated potable water pump installations, including piping valves, electrical and testing:

129AD619Q0007 Attachment 04

EXPERIENCE INFORMATION

SHEET

b. Hazardous Materials testing/abatement:

7. Work was performed as a: Prime Joint Venture Subcontractor

SOLICITATION NUMBER: 129AD619Q0007

TITLE: Arcata Fire and Water Pump Replacement

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