Attach (b) Corporate Experience Form.docx

CUI//FEDCON [when filled in] Source Selection Information - See FAR 2.101 & 3.104 [when filled in]

N4008422R6305 FHM at CFAS Japan

ATTACHMENT E - Offeror Experience Project Data Sheet

OFFEROR EXPERIENCE PROJECT DATA SHEET

The purpose of this form is to provide supporting project information for Factor 1 - Experience. This form is to be completed by the Offeror. Only projects that are within the maximum submittal number and that fit the submittal requirements will be considered for evaluation.

1. Contract Number:

2. Contracting Issuing Organization (or Prime Contractor):

3. Project Number and / or Title:

4. Project Location:

(Note: If worked as a subcontractor - List only the contract / project work that your company performed – do not list the prime contract.

2. Award Date (mm/dd/yyyy):

Period of Performance (From mm/dd/yyyy to mm/dd/yyyy):

Percentage of project complete: ________ %

3. Award Amount (Of the Offeror’s Work):

Final Contract Price (Including all options):

4. Type of work:

|_| New Construction |_| Construction Renovation |_| Construction Repair |_| Alteration

|_| Service: Facility operation, maintenance or repair

|_| Service: Utility Enovation |_|Repair |_|Alteration

5. Type of Contract:

|_|Construction: Design-Build |_| Construction: Design-Bid-Build |_| Service |_| Other (explain):

6. Your company performed the Work as: (check one) |_| Prime Contractor |_|Sub Contractor

If your firm was a subcontractor on this project, what was the percentage (%) of your work compared to the overall prime contract:

7. Customer/Owner/Prime Contractor Information:

Customer/Prime Name:

Point of Contact:

Phone Number:

FAX Number:

E-mail address:

8. Provide a detailed description of the project (the project work for which the Offeror was responsible for) including the specific types of work. Please address how the project is relevant to the current requirement in terms of size, scope, and complexity:

9. Provide a detailed description of what portion of the project work that your company (the Offeror) performed on the project with in-house/employee labor (DO NOT include any work you’re your company subcontracted out):

10. Provide a detailed description of what type of work and percentage of work that your company sub-contracted for the project. Identify the number of sub-contractors used, the type of work each subcontractor performed, and the overall percentage of work each subcontractor performed:

Note: Form may be expanded

CUI//FEDCON [when filled in] Source Selection Information - See FAR 2.101 & 3.104 [when filled in]