ATTACHMENT 3 - Specialized Experience Form.pdf
PDF 71 KB Posted
- Solicitation number
- 36C24826R0090
About this file
This is a Specialized Experience Form template used to document a contractor's relevant project experience for federal procurement evaluation purposes.
The form requires submission of exactly three (3) projects, with more than three projects not evaluated and fewer than three potentially resulting in lower ratings. For each project, offerors must provide: contractor information including firm name, address, DUNS number, CAGE code, and points of contact; contract/task order number and award date; project title and location; role performed (prime contractor, subcontractor, joint venture, or other); percentage of work performed by the company; prime contractor information if applicable; and government agency/contracting officer contact details. The form also requires detailed description of the project's scope of work and the offeror's specific roles and responsibilities, with emphasis on relevance to the current solicitation. Additional required information includes difficulties and obstacles encountered during performance and their resolution; unforeseen conditions and resolutions; performance period with contract start date and original/projected completion dates; actual completion date with explanation if incomplete; confirmation that the project is 50% or more complete (with lower ratings if below 50%); contract termination information if applicable; and original contract price, final contract price including all modifications, with explanation of any differences between them.
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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).
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:
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