ATTACHMENT D - Experience Information Sheet.pdf

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Attached to
Y1DA--PROJECT 675-24-104, Design-Build (DB) Upgrade Lake Nona Endoscopy Rooms
Solicitation number
36C24825R0010
Issued by

About this file

This document is an Experience Information Sheet for a federal contract opportunity. It provides details on the offeror's relevant experience, including the contract number, project title/location, work performed, prime/subcontractor status, government agency information, scope of work, performance period, contract pricing, and any difficulties or obstacles encountered.

The related federal contract opportunity is for Design-Build (D/B) Services to Upgrade Lake Nona Endoscopy Rooms, Project 675-24-104, issued by the Department of Veterans Affairs (VA), Veterans Integrated Service Network (VISN) 8. The solicitation is a two-phase design-build procurement with a total project value between $2,000,000 and $5,000,000. It is a 100% set-aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSB). The period of performance is 420 calendar days after issuance of the Notice to Proceed.

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EXPERIENCE INFORMATION SHEET

PROJECT NO. [ ] Page 1

a. Contractor Information of awarded contract (Firm Name, Address, DUNS Number and Cage Code, Phone number, POC Name, POC email, Company email)

b. Contract and/or Task Order Number and Award Date (mm/dd/yyyy)

c. Project Title/Name and Location

d. Work Performed as: Prime Contractor, Subcontractor, Joint Venture, Other (explain)

e. Percent (%) of project work performed by your company

f. If you work as subcontractor, who was the prime?

(Firm Name, Address, DUNS Number and Cage Code, Phone number, POC Name, POC email, Company email)

g. Government Agency/Company which awarded contract to offeror, and Contact Information, such Contracting Officer/Procurement Official/Point of Contract (Name, Title, Email, Phone Number).

PROJECT NO. [ ] Page 2

h. Description of project’s scope of work and the offeror’s specific roles and responsibilities in the project:

Describe work performed in sufficient detail to permit evaluation of project relevancy to this procurement. Detail how work performed is relevant to the effort required by the solicitation? Use continuation sheet for additional information, if necessary

ATTACHMENT G {3 PAGES}

PROJECT NO. [ ] Page 3

i. Describe any difficulties and/or obstacles encountered during performance; steps taken toward resolution

j. Describe unforeseen conditions and how each were resolved

k. Performance Period, including contract start date (mm/dd/yyyy), and original completion date, if not completed, projected date (mm/dd/yyyy) contract start date: original completion date, if not completed, projected completion date (mm/dd/yyyy)

l. Actual Completion Date (mm/dd/yyyy), and if not completed, why?

Actual Completion Date:

If not completed, Why?

m. Project is 50% or more complete? YES [ ] No [ ]. If “No” explain percentage of completion, if not 50% completed for any reason, rating may be lower.

n. The Offerors shall indicate if any of the contracts listed were terminated and the type and reasons for the termination.

o. Original Contract Price (Award Amount), Final Contract Price (to include all modifications, if applicable), Explain Differences.

Original Contract Price: Final Contract Price:

Explain Differences:

ATTACHMENT G {3 PAGES}

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