S02 EXHIBIT A FACTOR 1 INFORMATION SHEET-R2.docx
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- Solicitation number
- 36C24124R0065
About this file
This document is an EXHIBIT A: FACTOR 1 INFORMATION SHEET that requests detailed information about prior projects/contracts from the contractor. The required information includes the contractor firm, contract number, project number, NAICS code, project title, location, key points of contact, contract type, project delivery method, square footage, award and final amounts, dates, change orders, OSHA citations, major subcontractors, and a description of how the prior work is technically similar to the current project.
The related federal contract opportunity is Solicitation Number 36C24124R0065 for Z1DA--650-CSI-3516 Renovate Upgrade Angio OR Suite Construction, issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 1. This is a solicitation for construction services, though the specific scope of work is not detailed in the provided information.
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Text version
EXHIBIT A: FACTOR 1 INFORMATION SHEET
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.
FIRM/CONTRACTOR: ____________________________________________________________________________
CONTRACT NO: ___________________ PROJECT NO: ________________________ NAICS: ___________________
PROJECT TITLE: __________________________________________________________________________________
LOCATION: ______________________________________________________________________________________
CONTRACTING OFFICER/POC: _____________________________________________________________________
PHONE NO: ___________________________ E-MAIL ADDRESS: ___________________________________
OWNER’S PROJECT MANAGER/POC/COR: ________________________________________________________________
PHONE NO: ___________________________ E-MAIL ADDRESS: ___________________________________
ARCHITECT/ENGINEER/POC____________________________________________________
PHONE NO: ___________________ E-MAIL ADDRESS: _________________________
TYPE OF CONTRACT (Negotiated, Sealed Bid): _______________________________________________
PROJECT DELIVERY METHOD (Design/Build, Design/Bid/Build): ______________________________________________
SQUARE FOOTAGE OF EXPANSION SPACE: ________________
SQUARE FOOTAGE OF RENOVATION SPACE: ______________
FOUNDATION TYPE:________
AWARD AMOUNT: $__________________________ FINAL AMOUNT: $___________________________________
AWARD DATE: ___________________________________________________________________________________
NOTICE TO PROCEED DATE: _______________________________________________________________________
ORIGINAL SCHEDULED COMPLETION DATE: ________________________________________________________
ACTUAL COMPLETION DATE: _____________________________________________________________________
NUMBER OF CHANGE ORDERS/MODIFICATIONS AND REASON FOR CHANGES:
OSHA CITATIONS (If Applicable): ____________________________________________________________________
LIST ALL MAJOR SUBCONTRACTORS (W/POC & Phone Numbers):
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 DESCRIBED WITHIN THIS NOTICE. (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 you plan to use those same subcontractors 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. (if previous list of contacts is not current)
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