Attachment_12_-_Reference_List_0003.pdf
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- Attached to
- GAOA Statewide Radio Infrastructure Federal contract opportunity
- Solicitation number
- 140L3624R0011
About this file
This document is a Reference List form that is part of a solicitation for the GAOA Statewide Radio Infrastructure project issued by the Department of the Interior, Bureau of Land Management (BLM), Montana State Office.
The solicitation is for a construction contract, Firm Fixed Price (FFP), to remediate seven existing communications facilities across the state of Montana. The total contract value is between $250,000 and $500,000. This procurement is set-aside for Small Business Concerns. Offerors are required to provide a list of up to five relevant past performance projects that demonstrate their ability to successfully complete projects similar in scope, complexity, and magnitude. Key information requested includes the project name and location, description of work, prime and subcontractor roles, original and actual completion dates, initial and final contract amounts, and any problems encountered and corrective actions taken. Offerors are strongly encouraged to conduct a site visit to gain a better understanding of the work requirements. Proposals are due by the date specified in Standard Form 1442.
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Text version
Solicitation No: 140L3624R0011 PROJECT DESCRIPTION: GAOA Statewide Radio Infrastructure
REFERENCE LIST
The contractor shall furnish a list (no more than five) of Federal, State, local government or commercial projects similar in scope, complexity, and magnitude to the work required under this solicitation that the contractor has completed within the last five years. These projects must clearly demonstrate the contractor’s successful ability to accomplish projects in a timely and satisfactory manner. If an offeror intends to utilize subcontractors to perform any of the major components of work, all the requested information must be provided for each proposed subcontractor.
CONTRACTOR NAME: _____________________________________________________________________
Submitting Proposal as (select one) Prime Contractor Subcontractor
If submitting as Subcontractor, your prime contractor is
1. Name and Location of Project: ________________________________________________________________________________________
Description of Work: __________________________________________________________________________
Prime Contractor: _____________________________________________________________________________
Subcontractor(s): _____________________________________________________________________________
Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______
Original Completion Date: _____________________ Actual Completion Date: ______________________
Initial Contract Amount: _______________________ Final Contract Amount: _______________________
Name, Address, and Phone Number of Point of Contact: ______________________________________________
Problems Encountered and Corrective Actions Taken: ________________________________________________
2. Name and Location of Project: ________________________________________________________________________________________
Description of Work: __________________________________________________________________________
Prime Contractor: _____________________________________________________________________________
Subcontractor(s): _____________________________________________________________________________
Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______
Original Completion Date: _____________________ Actual Completion Date: ______________________
Initial Contract Amount: _______________________ Final Contract Amount: _______________________
Name, Address, and Phone Number of Point of Contact: ______________________________________________
Problems Encountered and Corrective Actions Taken: ________________________________________________
Solicitation No: 140L3624R0011 PROJECT DESCRIPTION: GAOA Statewide Radio Infrastructure
3. Name and Location of Project: ________________________________________________________________________________________ Description of Work: __________________________________________________________________________
Prime Contractor: _____________________________________________________________________________ Subcontractor(s): _____________________________________________________________________________ Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______ Original Completion Date: _____________________ Actual Completion Date: ______________________ Initial Contract Amount: _______________________ Final Contract Amount: _______________________ Name, Address, and Phone Number of Point of Contact: ______________________________________________
Problems Encountered and Corrective Actions Taken: ________________________________________________
4. Name and Location of Project: ________________________________________________________________________________________ Description of Work: __________________________________________________________________________
Prime Contractor: _____________________________________________________________________________ Subcontractor(s): _____________________________________________________________________________ Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______ Original Completion Date: _____________________ Actual Completion Date: ______________________ Initial Contract Amount: _______________________ Final Contract Amount: _______________________ Name, Address, and Phone Number of Point of Contact: ______________________________________________
Problems Encountered and Corrective Actions Taken: ________________________________________________
5. Name and Location of Project: ________________________________________________________________________________________ Description of Work: __________________________________________________________________________
Prime Contractor: _____________________________________________________________________________ Subcontractor(s): _____________________________________________________________________________ Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______ Original Completion Date: _____________________ Actual Completion Date: ______________________ Initial Contract Amount: _______________________ Final Contract Amount: _______________________ Name, Address, and Phone Number of Point of Contact: ______________________________________________
Problems Encountered and Corrective Actions Taken: ________________________________________________
| REFERENCE LIST |
| CONTRACTOR NAME: _____________________________________________________________________ |
| Prime Contractor |
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