Attachment_J11_-_Company_Specialized_Experience_Form_Construction.docx

16-161-SOL-00001

NCYRTC

Attachment J11. Company Specialized Experience – Construction Form Solicitation 75H701-19-R-00054

COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM

Provide the following information to show examples of projects your company constructed within the last five (5) years indicating experience with projects of similar type and scope. Use one form per project.

Type of Project Represented Your Firm’s Name Name of Project Location of Project Owner General Scope of Construction Project Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed :

Construction Cost Extent and Type of Work Subcontracted Out Dates Construction: Began___________________ Completed______________ % Completed _______ Your Performance Evaluation by Owner, if known Were You Terminated or Assessed Liquidated Damages?

(If either is “Yes”, attach an Explanation) Owner’s Point of Contact for Reference (Name and Company) Current Telephone Number of Reference POC

SOURCE SELECTION SENSITIVE For Official Use Only

Volume I – Factor 1 – Specialized Experience

FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)

Response to Solicitation 75H701-19-R-00054