Project_Experience_Questionnaire.docx
DOCX document 17 KB Posted
- Solicitation number
- AG-9AB5-S-17-0047
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Relevant Project Experience Questionnaire
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Text version
PROJECT EXPERIENCE QUESTIONNAIRE
| (Offerors must complete this form for evaluation purposes) |
| NAME OF FIRM |
| POINT OF CONTACT |
TELEPHONE NO.
FAX NO.
PRIOR PROJECT EXPERIENCE
(TO BE COMPLETED BY THE OFFEROR - LIST UP TO FIVE (5) INDIVIDUAL PROJECTS)
PROJECT DESCRIPTION
(USE BLANK PAGE IF NECESSARY)
| CONTRACT/PROJECT NO. |
| LOCATION |
| CONTRACT AMOUNT (ROUND TO NEAREST DOLLAR) |
| ORIGINAL |
| FINAL |
1.
| $ |
| $ |
2.
| $ |
| $ |
3.
| $ |
| $ |
4.
| $ |
| $ |
5.
| $ |
| $ |
| NAME OF CLIENT/AGENCY |
| POINT OF CONTACT |
| TELEPHONE NO. |
| FACSIMILE NO. |
1.
2.
3.
4.
5.
| ORIGINAL PROJECT DATES |
| WERE YOU A PRIME CONTRACTOR OR SUBCONTRACTOR? |
| WERE THERE CONTRACT MODIFICATIONS? (YES/NO) |
| HOW MANY? |
| WHO INITIATED THEM? CLIENT, CONTRACTOR OR BOTH? |
| START |
| COMPLETION |
1.
2.
3.
4.
5.
| WERE THERE ANY TIME EXTENSIONS? (YES/NO) |
| IF SO, INDICATE NEW COMPLETION DATE? |
| WAS THE SCHEDULE MET? |
(YES/NO)
IF NOT, WHAT WAS THE REASON?
(USE BLANK PAGE IF NECESSARY)
1.
2.
3.
4.
5.
| HAVE YOU EVER ENTERED A DISPUTE? (YES/NO) |
| IF SO, WHAT WAS THE REASON? |
(USE BLANK PAGE IF NECESSARY)
HAVE YOU EVER
BEEN DEFAULTED?
(YES/NO)
IF SO, WHAT WAS THE REASON?
(USE BLANK PAGE IF NECESSARY)
1.
2.
3.
4.
5.
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