36C24818R0454-00001003.pdf

36C24818R0454 – Renovate Building 500 for VBA

CONTRACTOR EXPERIENCE FORM

1. Project name and location (City, State, Country)

2. Project owners name and address: (Government Agency, commercial firm or other organization)

3. Project owners Point of Contract Information: (name, phone, email address)

4. Were you the Prime Contractor? YES NO Percentage of work that was self-performed? %

5. Contract number of project 6. Date of contract

7. Date work began 8. Completion Dates:

Initial:

Actual:

9. Project Completion Percentage (%)

8. Contract Value at Time of Award 9. Final invoiced amount (or amount invoiced to date)

10. Description of Construction contract work - describe nature and scope of work. Detail how project demonstrates experience requirements Use continuation sheet for additional information, if necessary.

11. Current status of project (check one) Work continuing, on schedule Work continuing, behind schedule Work completed, no further action pending Work completed, routine administrative action pending Work completed, claims negotiation pending/underway Work completed, litigation pending/underway Terminated for convenience Terminated for default Other (Explain, use additional sheets as necessary)

Attachment 3