RFP Attachment J04 Company Specialized Experience Construction Form.docx
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- Solicitation number
- 75H70124R00043
About this file
This document is a Company Specialized Experience - Construction Form that is an attachment to a Request for Proposal (RFP) for the renovation of the Lower Brule Indian Health Center (IHC) Pharmacy in Lower Brule, South Dakota. The RFP solicitation number is 75H70124R00043.
The form requires the offeror to provide details on a recent construction project that is similar in type and scope to the current requirement, including the project type, location, owner, scope, facility type and size, the offeror's role and work performed, the contract value, subcontracted work, construction dates, performance evaluation by the owner, and contact information for a reference. This information is intended to demonstrate the offeror's specialized construction experience relevant to the current requirement. The overall project is a renovation to meet compounding requirements, with a period of performance of 180 calendar days and an anticipated contract value between $500,000 and $1,000,000. The procurement is set aside for small businesses under NAICS code 236220 with a $45 million size standard.
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Text version
16-161-SOL-00001
NCYRTC
Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H70124R00043
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
Provide the following information to show examples of projects your company constructed within the last six (6) 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 Type of Facility (i.e. office building, hospital, etc.)
Size of building, including number of gross square feet and number of stories Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed Dollar Value of the Contract 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)
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