Attachment_16_-_Relevant_Experience_Project_Template_AMD0005.docx

DOCX document 42 KB Posted

Attached to
ONE OIT Federal contract opportunity
Solicitation number
503102-18-R-0005
Issued by
Securities and Exchange Commission

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Attachment 16 - Relevant Experience Project Template_AMD0005

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Attachment 16: Relevant Experience Project Template (Document Verification)

Part 1: Project Identification

Offeror Name:
Click here to enter text.
Contractor Name if other than Offeror (Restricted Pool Only):
Click here to enter text.
Contract Number:
Click here to enter text.
Order Number (if applicable)
Click here to enter text.
Project Title:
Click here to enter text.
Prime or Subcontractor:
Choose an item.
Contract Type:
Choose an item.
Period of Performance (PoP):
MM/YYYY – MM/YYYY or MM/YYYY - Present.
PoP if all options are exercised:
Choose an item.
Obligated Amount:
Click here to enter text.
Base and All Options Value (Total Contract Value):
Click here to enter text.
NAICS:
Click here to enter text.
PSC Code
Click here to enter text.

Part 2: Project Reference Information

Contracting Officer (or Corporate Official for Commercial Experience)

Name:
Click here to enter text.
Title:
Click here to enter text.
Agency or Customer:
Click here to enter text.
Phone:
Click here to enter text.
Email:
Click here to enter text.

Contracting Officer’s Representative (COR)/Federal Program Manager (FPM) (Complete only if COR/FPM providing signature verification in Part 4)

Name:
Click here to enter text.
Title :
Click here to enter text.
Agency:
Click here to enter text.
Phone:
Click here to enter text.
Email:
Click here to enter text.

Part 3: Project Description (If performed as Subcontractor, explain your role in accomplishing the project objectives)

Click here to enter text.

Part 4: Project Verification (Convert to .pdf before signing)

Signature below by a Contracting Officer, Contracting Officer’s Representative, Federal Program Manager, or Corporate Official constitutes acceptance of the above project information to be accurate as ordered and received by the listed entity.

NOTE: Signature by Contracting Officer’s Representative/Federal Program Manager must include copy of email notification to the cognizant Contracting Officer.

Name: Click here to enter text.

Date: Click here to enter text.

Signature:

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