1333ND19QNB680513_ATCH_A_Experience_Project_Data_Sheet.docx

1333ND19QNB680513 Atomic Force Microscope – Experience Project Data Sheet Attachment A

COVER (PAGE) MUST INCLUDE:

A. Prime Contractor’s Name

1. DUNS

2. Contact Information for 2 Individuals:

a. Name

b. Phone

c. Email or Fax #

d. Address

e. ALTERNATES:

f. Name

g. Phone

h. Email or Fax #

i. Address B. Entity Making Submittal: Parent Company___ Subsidiary ___ Division ___ Branch Office ___ C. Year company/entity was established: __________ D. Sub Contractor’s Names:

a. Name

b. Phone

c. Email or Fax #

d. Address

e. ALTERNATES:

f. Name

g. Phone

h. Email or Fax #

i. Address

EXPERIENCE PROJECT DATA 1

ADD PHOTO

1. Name of the project (to include address);

2. Project Prime’s Name;

3. Proposed Prime for Solicitation? [Yes or No] (Is the offeror on this solicitation the prime contractor of this project?);

4. If “No”, what is the offeror’s role, and relationship to the (i.e. subcontractor, joint venture etc.) on the project:

5. Issuing Agency or Company;

6. Contract/Identification Number;

7. Start and completion dates;

8. Brief description of the scope of work;

9. Award Amount (in whole dollars);

10. How the work is relevant to the proposed project (Reference definition for comparable);

11. A valid reference that includes:

a. Agency/Company’s name;

b. Point of Contact’

c. Phone Number and;

d. Email Address;

12. Associated key personnel and key management personnel and their role in project or tasks performed;

13. Was this project completed by the proposed team (prime and subcontractor(s))? [Yes or No]

14. List any challenges performing the project. (Was it on time, within budget, safety violation, good administration etc.).

EXPERIENCE PROJECT DATA 2

3. Proposed Prime for Solicitation? [Yes or No] (Is the offeror on this solicitation the prime contractor of this project?);

4. If “No”, what is the offeror’s role, and relationship to the (i.e. subcontractor, joint venture etc.) on the project:

5. Issuing Agency or Company;

6. Contract/Identification Number;

7. Start and completion dates;

8. Brief description of the scope of work;

9. Award Amount (in whole dollars);

10. How the work is relevant to the proposed project (Reference definition for comparable);

11. A valid reference that includes:

a. Agency/Company’s name;

b. Point of Contact’

c. Phone Number and;

d. Email Address;

12. Associated key personnel and key management personnel and their role in project or tasks performed;

14. List any challenges performing the project. (Was it on time, within budget, safety violation, good administration etc.).

EXPERIENCE PROJECT DATA 3

3. Proposed Prime for Solicitation? [Yes or No] (Is the offeror on this solicitation the prime contractor of this project?);

4. If “No”, what is the offeror’s role, and relationship to the (i.e. subcontractor, joint venture etc.) on the project:

5. Issuing Agency or Company;

6. Contract/Identification Number;

7. Start and completion dates;

8. Brief description of the scope of work;

9. Award Amount (in whole dollars);

10. How the work is relevant to the proposed project (Reference definition for comparable);

11. A valid reference that includes:

a. Agency/Company’s name;

b. Point of Contact’

c. Phone Number and;

d. Email Address;

12. Associated key personnel and key management personnel and their role in project or tasks performed;

14. List any challenges performing the project. (Was it on time, within budget, safety violation, good administration etc.).

[OFFEROR’S INFORMATION (I.E. NAME, LOGO ECT.)] Page 9 of 12 image1.jpg