Attachment 05 - Specialized Experience Form - 3 Pages.pdf

PDF 456 KB Posted

Attached to
Z2DA--Resurface Parking Garage C Federal contract opportunity
Solicitation number
36C24826R0035
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8

About this file

The document is a Specialized Experience Form template designed for contractors to detail their past project experience when bidding on a federal contract opportunity. The form requires comprehensive documentation of three specific projects, with clear instructions that submitting more than three projects will not be evaluated, and fewer than three may result in a lower rating.

The form is structured to capture detailed information about each project, including contractor details, contract numbers, project titles, work performance roles, percentage of work completed, prime contractor information, government agency contacts, project scope, specific roles and responsibilities, challenges encountered, performance periods, contract prices, and project completion status. Each section prompts for precise information that would help an evaluating agency assess the contractor's relevant experience and capability to perform on the proposed contract.

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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).

File details come from the government source that posted it. Updated .