Attachment 39 - Project Information Sheet for Contractors.docx

DOCX document 15 KB Posted

Attached to
Z2DA--620-22-700 Electronic Health Record Modernization Infrastructure Upgrades - Franklin Delano Roosevelt VA Hospital, Montrose, NY
Solicitation number
RFP-36C77626R0033
Issued by

About this file

This is a Project Information Sheet template for contractors to document their experience on relevant contracts as part of their proposal response.

The form requires contractors to submit detailed information for each project or contract they are highlighting, including their company name, role (prime or subcontractor), contract and project numbers, NAICS code, project title, location, and key points of contact from both the contracting officer and owner's project manager. Contractors must provide contract award and final amounts, award date, notice to proceed date, original and actual completion dates, the number of change orders with reasons, and any applicable OSHA citations. The form also requires a comprehensive list of all major subcontractors with points of contact and phone numbers. The narrative section requires contractors to provide a detailed description of work performed and justify the relevance of the project to the current opportunity, categorizing the work as very relevant, relevant, or somewhat relevant. This form is aligned with NAICS 236220 (Commercial and Institutional Building Construction) and appears designed for the Electronic Health Record Modernization Infrastructure Upgrades project at Franklin Delano Roosevelt VA Hospital in Montrose, NY, which is a Small Business Set-Aside competitive solicitation administered by the Department of Veterans Affairs Technology Acquisition Center.

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ATTACHMENT 03

PROJECT INFORMATION SHEET FOR CONTRACTORS

The experience presented on this form must be in accordance with all Request for Proposal instructions. Provide a separate completed form for each contract/project submitted.

NAICS

236220 Commercial and Institutional Building Construction

Provide the following information requested in this format for each of the projects/contracts being described. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you identify. Use as much space as required.

OFFEROR (YOUR) NAME (COMPANY/DIVISION):

ROLE ON CONTRACT (PRIME OR SUBCONTRACTOR):

CONTRACT NO:

PROJECT NO:

NAICS:

PROJECT TITLE:

LOCATION:

CONTRACTING OFFICER/POC:

PHONE NO:

E-MAIL ADDRESS:

OWNER’S PROJECT MANAGER/POC (For example the COR):

PHONE NO:

E-MAIL ADDRESS:

TYPE OF CONTRACT (Negotiated, Design/Build):

AWARD AMOUNT: $ FINAL AMOUNT: $ AWARD DATE:

NOTICE TO PROCEED DATE:

ORIGINAL SCHEDULED COMPLETION DATE:

ACTUAL COMPLETION DATE:

NUMBER OF CHANGE ORDERS AND REASON FOR CHANGES:

OSHA CITATIONS (If Applicable):

LIST ALL MAJOR SUBCONTRACTORS (W/POC & Phone Numbers):

NARRATIVE:

Provide detailed description of the work performed under the contract and describe why you believe the work is very relevant, relevant, or somewhat relevant.

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