Project Experience Questionnaire.docx
DOCX document 105 KB Posted
- Solicitation number
- 36C77624R0140
About this file
This is a Project Experience Questionnaire template issued by the VA Program Contracting Activity Central in Independence, OH, for contractors to detail their relevant project experience. The questionnaire requests information about previous projects including project title, location, description, owner details, and contractor information (both prime and subcontractors). It specifically asks contractors to address five key areas: general project work description, relevance to current solicitation elements (particularly regarding greenfield civil work, multi-discipline coordination, medical gases, medical facility experience, and construction challenges around medical imaging equipment), explanations of price changes, schedule changes, and any additional relevant project information.
The questionnaire is related to solicitation 36C77624R0140 for a Design Build Storage Building Replacement Project at the Iowa City VAMC. While the template allows for expanded responses and inclusion of supporting materials like photos and charts, it emphasizes adherence to project quantity and timeframe limits specified in the main solicitation. The form requires detailed cost breakdowns, original and final performance periods, and specific roles of all contractors involved in the referenced projects.
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Text version
VA PROGRAM CONTRACTING ACTIVITY CENTRAL ● 6100 OAK TREE BLVD SUITE 490 ● INDEPENDENCE, OH 44131
Project Experience Questionnaire
Submit responses to the questions below that address experience relative to the elements within the current solicitation. Limit submittals to the quantity of projects and timeframes required in the solicitation. Expand the response sections shown below as needed to adequately address each question (this questionnaire may be expanded to multiple pages if needed). Including any photos, narratives, and charts that may help demonstrate project experience and relevancy.
| Offeror |
| Company Name |
REFERENCED PROJECT INFORMATION
| Project Title |
| Title |
| Project Location |
| City, State |
| Brief Project Description |
| Description |
| Project Owner |
| Company Name |
| POC: |
| First & Last Name |
| Phone: |
| (XXX) XXX-XXXX |
CONTRACTOR LIST
List Contractor(s) whose experience on the referenced project is being submitted for evaluation on this proposed project. If more than one contractor is listed (i.e. prime and subcontractors), provide information specific to that contractor.
| Contractor Name |
| Role on Referenced Project |
(Prime or Sub)
| Trade |
| Price |
(list for each contractor’s specific work) Performance Period (calendar days) (list for each contractor’s specific work)
| Original |
| Final |
| Original |
| Final |
| Name |
| Prime |
| Prime |
| $XXX |
| $X,XXX |
| XX |
| XX |
| Name |
| Subcontractor |
| Plumbing |
| $X,XXX, |
| $X,XXX |
| XXX |
| XXX |
| Name |
| Subcontractor |
| Mechanical |
PROJECT EXPERIENCE QUESTIONS
1. Describe the project work.
Response
2. Identify which Project Experience elements relate to the current solicitation. Specifically address: greenfield civil work, multi-discipline coordination, working with medical gases, working at medical facility, and consideration of construction challenges around large medical imaging equipment, if applicable.
Response
3. Describe & provide reasons for any changes to the original price for the project.
Response
4. Describe and provide reasons for any changes to the original schedule for the project.
Response
5. Provide any other additional project information you believe should be presented.
Response image1.tiff
File details come from the government source that posted it. Updated .