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SOURCES SOUGHT – CONSTRUCTION EXPERIENCE PROJECT DATA FORM
for 36C26118R0541 IPP USP 797/800 Compliance (Pharmacy), VASNHCS Reno, Nevada
Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to three (3) projects. Please limit response to two pages per project.
| 2. | | | | |
| Project No. (check one): | | | | |
| |_| - 1 | |_| - 2 | |_| - 3 | |_| - 4 | |_| - 5 |
| 3. |
| Contract Number: |
| Delivery/Task Order No.: |
| 4. |
| Award Date (mm/dd/yy): |
| 5. |
| Final Contract Price: |
| $ |
| Completion Date (mm/dd/yy): |
| (includes all options and mods) |
| Project is % complete (as of submission due date) |
| This is the |_| total project |_| subcontract price. |
| 6. | | |
| Type of work: | | |
| |_| New Construction | |_| Repair | |_| Renovation |
| Point of Contact Name/Title: (person with project knowledge) |
| POC Phone Number: |
| POC Email Address: |
| 8. | |
| Were you the Prime contractor for this project? | |
| |_| Yes | |_| No |
| Were you a subcontractor for this project? | |
| |_| Yes | |_| No |
| If subcontractor, who was the Prime contractor? |
| 9. |
| Type of Contract (check all that apply): |
|_| Design-Build |_| Design-Bid-Build (fully designed project)
| If Design-Build, provide the following information: |
| |_| Design accomplished in-house |
| Lead design firm name: |
| Years working together: |
10. Provide a detailed description of the project:
11. Percentage of work you self-performed on this project: %.
Provide a detailed description of the work your firm self-performed on this project:
Form may be expanded. Please DO NOT change content of the form.
