36C24119R0045-007.docx

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VISN 1 SATOC Providence
Solicitation number
36C24119R0045
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This document contains a past performance information form template and a presolicitation notice for a construction procurement. The past performance information form requests details on previous projects including location, contract details, subcontractors used, and a description of work performed. The presolicitation notice is for two single award task order contracts for construction work at VA medical centers in Bedford, Massachusetts and Providence, Rhode Island. The majority of task orders are expected to be between $25,000 to $75,000 with a $500,000 ceiling to primarily involve repairs, renovations and minor alterations. The set-aside is for Service Disabled Veteran Owned or Veteran Owned Small Businesses. The NAICS code is 236220 and small business size standard is $36.5 million. One contract will be awarded per location for an initial one year base period and four option years.

36C24119R0045 PAST PERFORMANCE INFORMATION FORM.docx

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PAST PERFORMANCE INFORMATION FORM

Provide the following information requested in this format for each of the projects/contracts being described. Projects may be on going and cannot have been competed any later than Five (5) years prior to the solicitation issue date.

OFFEROR: ____________________________________________________________________

CONTRACT NO.________________PROJECT NO.__________________ NAICS: __________

PROJECT TITLE: _______________________________________________________________

LOCATION: __________________________________________________________________

CONTRACTING OFFICER/POC: __________________________________________________

PHONE NO: ________________ E-MAIL ADDRESS: ___________________________

OWNER’S PROJECT MANAGER/POC_____________________________________________

PHONE NO: ________________E-MAIL ADDRESS: ____________________________

ARCHITECT/ENGINEER/POC____________________________________________________

PHONE NO: ___________________ E-MAIL ADDRESS: _________________________

TYPE OF CONTRACT (Negotiated, Design/Build, Design/Bid/Build) _______________________________________

SQUARE FOOTAGE: _______ FOUNDATION TYPE:________

AWARD AMOUNT: $___________________ FINAL AMOUNT: $_______________________

ORIGINAL SCHEDULED COMPLETION DATE:________________________________________________________

ACTUAL COMPLETION DATE: _____________________________________________________________________

OSHA CITATIONS (If Applicable) ____________________________________________________________________

LIST ALL MAJOR SUBCONTRACTORS (W/POC & Phone Numbers)

Modifications: _________________________________________________________________________

DESCRIPTION OF PROJECT – Address project scope of work and explain how the project involved work as a prime contract was technically similar to the project under this solicitation. (May be continued on a blank page, if necessary)

In addition, address the following (May be continued on a blank page, if necessary):

Describe the specific elements of the work performed by your firm ______________________________

Indicate what elements of work were performed by your major subcontractors and indicate if those same subcontractors will be used on this project _______________________________________________

Address any technical areas about this project you consider uniquely relevant to this solicitation _____

· Include a current phone number and email address for point of Contact for Owner/Government agency Contracting Officer and or inspector.

File details come from the government source that posted it. Updated .