Attachment 05 - Specialized Experience Form - 3 pages.pdf
PDF 189 KB Posted
- Solicitation number
- 36C24825R0023
About this file
This is a 3-page Specialized Experience Form template requiring offerors to provide detailed information about four previous projects to demonstrate relevant experience for a VA boiler replacement project in San Juan, PR. The form must be completed with exactly four projects - more will not be evaluated and fewer may result in a lower rating.
The form requires comprehensive project details including: contractor information (firm name, DUNS, CAGE code, POC details); contract/task order numbers and dates; project descriptions; role as prime/sub/JV; percentage of work performed; prime contractor details if serving as sub; government agency/CO contact information; scope of work descriptions; difficulties encountered and resolutions; performance period dates; completion status (must be at least 50% complete); contract termination information if applicable; and original/final contract prices with explanations for any differences. Each project submission must demonstrate relevancy to the current procurement and include sufficient detail to permit evaluation of the offeror's capabilities.
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SPECIALIZED EXPERIENCE FORM
SPECIALIZED EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 1 Must have a total of four (4) projects, more than 4 will not be evaluated; less than 4 may result in a lower rating.
a. Contractor Information of awarded contract (Firm Name, Address, DUNS Number and Cage Code, Phone number, POC Name, POC email, Company email)
b. Contract and/or Task Order Number and Award Date (mm/dd/yyyy)
c. Project Title/Name and Location
d. Work Performed as: Prime Contractor, Subcontractor, Joint Venture, Other (explain)
e. Percent (%) of project work performed by your company
f. if you work as subcontractor, who was the prime?
(Firm Name, Address, DUNS Number and Cage Code, Phone number, POC Name, POC email, Company email)
g. Government Agency/Company which awarded contract to offeror, and Contact Information, such Contracting Officer/Procurement Official/Point of Contract (Name, Title, Email, Phone Number).
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EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 2
h. Description of project’s scope of work and the offeror’s specific roles and responsibilities in the project:
Describe work performed in sufficient detail to permit evaluation of project relevancy to this procurement. Detail how work performed is relevant to the effort required by the solicitation? Use continuation sheet for additional information, if necessary
EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 3
i. Describe any difficulties and/or obstacles encountered during performance; steps taken toward resolution
j. Describe unforeseen conditions and how each were resolved
k. Performance Period, including contract start date (mm/dd/yyyy), and original completion date, if not completed, projected date (mm/dd/yyyy) contract start date: original completion date, if not completed, projected completion date (mm/dd/yyyy)
l. Actual Completion Date (mm/dd/yyyy), and if not completed, why?
Actual Completion Date:
If not completed, Why?
m. Project is 50% or more complete? YES [ ] No [ ]. If “No” explain percentage of completion, if not 50% completed for any reason, rating may be lower.
n. The Offerors shall indicate if any of the contracts listed were terminated and the type and reasons for the termination.
o. Original Contract Price (Award Amount), Final Contract Price (to include all modifications, if applicable), Explain Differences.
Original Contract Price: Final Contract Price:
Explain Differences:
File details come from the government source that posted it. Updated .