Attachment_4_-_140L3625R0011_Reference_List.pdf

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Attached to
GAOA - Glasgow Stream Crossing Improvements Federal contract opportunity
Solicitation number
140L3625R0011
Issued by
Department of the Interior Bureau of Land Management

About this file

The document is a Reference List form for a federal contract solicitation (No. 140L3625R0011) for the GAOA Glasgow Stream Crossing Improvements project. The form requires contractors to provide details on up to five previous federal, state, local government, or commercial projects completed within the last five years that are similar in scope, complexity, and magnitude to the current solicitation. For each project, contractors must document project name and location, work description, prime and subcontractor information, percentage of work performed, completion dates, contract amounts, point of contact, and any problems encountered with corrective actions taken.

The form is designed to help the Department of Interior's Bureau of Land Management assess a contractor's capability and past performance, with specific emphasis on demonstrating successful project completion. Contractors must fill out all sections thoroughly, including details about subcontractors if they are part of the proposed team. This reference list will be used as part of the evaluation process for the stream crossing improvements project in Valley County, Montana, which involves installing culverts, repairing erosion damage, and constructing low-water crossings at three specific locations.

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Text version

Solicitation No: 140L3625R0011

PROJECT DESCRIPTION: GAOA GLASGOW STREAM CROSSING IMPROVEMENTS

REFERENCE LIST

The contractor shall furnish a list (no more than five) of Federal, State, local government or commercial projects similar in scope, complexity, and magnitude to the work required under this solicitation that the contractor has completed within the last five years. These projects must clearly demonstrate the contractor’s successful ability to accomplish projects in a timely and satisfactory manner. If an offeror intends to utilize subcontractors to perform any of the major components of work, all the requested information must be provided for each proposed subcontractor.

CONTRACTOR NAME: _____________________________________________________________________

Submitting Proposal as (select one) Prime Contractor Subcontractor

If submitting as Subcontractor, your prime contractor is

1. Name and Location of Project: ________________________________________________________________________________________

Description of Work: __________________________________________________________________________

Prime Contractor: _____________________________________________________________________________

Subcontractor(s): _____________________________________________________________________________

Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______

Original Completion Date: _____________________ Actual Completion Date: ______________________

Initial Contract Amount: _______________________ Final Contract Amount: _______________________

Name, Address, and Phone Number of Point of Contact: ______________________________________________

Problems Encountered and Corrective Actions Taken: ________________________________________________

2. Name and Location of Project: ________________________________________________________________________________________

Description of Work: __________________________________________________________________________

Prime Contractor: _____________________________________________________________________________

Subcontractor(s): _____________________________________________________________________________

Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______

Original Completion Date: _____________________ Actual Completion Date: ______________________

Initial Contract Amount: _______________________ Final Contract Amount: _______________________

Name, Address, and Phone Number of Point of Contact: ______________________________________________

Problems Encountered and Corrective Actions Taken: ________________________________________________

Solicitation No: 140L3625R0011

PROJECT DESCRIPTION: GAOA GLASGOW STREAM CROSSING IMPROVEMENTS

3. Name and Location of Project: ________________________________________________________________________________________ Description of Work: __________________________________________________________________________

Prime Contractor: _____________________________________________________________________________ Subcontractor(s): _____________________________________________________________________________ Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______ Original Completion Date: _____________________ Actual Completion Date: ______________________ Initial Contract Amount: _______________________ Final Contract Amount: _______________________ Name, Address, and Phone Number of Point of Contact: ______________________________________________

Problems Encountered and Corrective Actions Taken: ________________________________________________

4. Name and Location of Project: ________________________________________________________________________________________ Description of Work: __________________________________________________________________________

Prime Contractor: _____________________________________________________________________________ Subcontractor(s): _____________________________________________________________________________ Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______ Original Completion Date: _____________________ Actual Completion Date: ______________________ Initial Contract Amount: _______________________ Final Contract Amount: _______________________ Name, Address, and Phone Number of Point of Contact: ______________________________________________

Problems Encountered and Corrective Actions Taken: ________________________________________________

5. Name and Location of Project: ________________________________________________________________________________________ Description of Work: __________________________________________________________________________

Prime Contractor: _____________________________________________________________________________ Subcontractor(s): _____________________________________________________________________________ Percentage (%) of Work Performed by Prime: _________ % of Work Performed by Subcontractor(s): _______ Original Completion Date: _____________________ Actual Completion Date: ______________________ Initial Contract Amount: _______________________ Final Contract Amount: _______________________ Name, Address, and Phone Number of Point of Contact: ______________________________________________

Problems Encountered and Corrective Actions Taken: ________________________________________________

REFERENCE LIST
CONTRACTOR NAME: _____________________________________________________________________
Prime Contractor

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