Attachment 3 - Project Data Sheet.doc

ATTACHMENT 4

PROJECT DATA SHEET

Project (check one): FORMCHECKBOX Contract 1 FORMCHECKBOX Contract 2 FORMCHECKBOX Contract 3 FORMCHECKBOX Contract 4 FORMCHECKBOX Contract 5

FORMCHECKBOX

Contract 6 FORMCHECKBOX Contract 7 FORMCHECKBOX Contract 8 FORMCHECKBOX Contract 9 FORMCHECKBOX Contract 10

1. Experience for: FORMCHECKBOX Offeror FORMCHECKBOX Joint-Venture FORMCHECKBOX Subcontractor (Explain)_______________ Firm Name:

UEI #:

Address:

Phone Number:

Point of Contact: Contact Phone Number:

2. Work Performed as: FORMCHECKBOX Prime Contractor FORMCHECKBOX Sub Contractor FORMCHECKBOX Joint Venture FORMCHECKBOX Other (Explain) Percent of project work performed:

If subcontractor, who was prime (Name/Phone #):

3. Contract Number: Delivery/Task Order Number:

Title:

Location:

Contract Dollar Value:

Award date (mm/dd/yy): Completion Date (mm/dd/yy):

4. Type of work monitored:

FORMCHECKBOX

New Construction FORMCHECKBOX Renovation FORMCHECKBOX Repair FORMCHECKBOX Alteration FORMCHECKBOX Other (explain):

5. Type of Contract/Task Order (Check ALL that apply):

FORMCHECKBOX

Firm-Fixed Price FORMCHECKBOX Cost/Time and Material FORMCHECKBOX

6. Construction Project:

Award Amount: Final Price:

Type of Construction Contract/Task Order (Check ALL that apply):

FORMCHECKBOX

Design-Build FORMCHECKBOX Design-Bid-Build FORMCHECKBOX Delivery/Task Order (IDIQ) FORMCHECKBOX

If Design-Build, identify the Lead Design Firm: _____________________________________________

7. Customer/Owner Name:

Point of Contact (POC): POC Phone Number:

FAX Number: POC E-mail address:

8. Provide a detailed description of the project, the services provided, and the relevancy to the project requirements of this RFP:

9. Provide a detailed description of what work your firm self-performed on this project:

10. Other Information:

Attachment 4