Attachment 05 - Specialized Experience Form - 3 Pages.pdf
PDF 193 KB Posted
- Attached to
- Z2DA--Construct New Hybrid Operating Room Federal contract opportunity
- Solicitation number
- 36C24825R0026
About this file
The Specialized Experience Form is a three-page document designed for contractors to provide detailed information about three past projects relevant to a Department of Veterans Affairs construction solicitation for a new hybrid operating room in San Juan, Puerto Rico. The form requires comprehensive project documentation, including contractor information, contract details, project scope, roles and responsibilities, performance challenges, completion status, and contract pricing.
The form instructs offerors to describe each project's work in sufficient detail to demonstrate relevance to the current procurement, with specific emphasis on explaining how past work relates to the solicitation requirements. Key evaluation criteria include project completion percentage (must be 50% or more), performance period, any contract terminations, and changes in original versus final contract pricing. Contractors must carefully document their experience to receive a favorable rating, as the solicitation explicitly states that providing fewer than three projects may result in a lower evaluation score.
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Text version
SPECIALIZED EXPERIENCE FORM
SPECIALIZED EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 1 Must have a total of three (3) projects, more than 3 will not be evaluated; less than 3 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).
VHASAJALVARA
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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 .