Attachment_4_-_Reference_List.pdf
PDF 336 KB Posted
- Attached to
- GAOA SOUTH PRYOR ROADS
- Solicitation number
- 140L3626R0001
About this file
This document is a Reference List form for solicitation number 140L3625R0012 for the GAOA Chain of Lakes Potable Water System Replacement project. Contractors submitting proposals must provide a list of no more than three Federal, State, local government, or commercial projects completed within the last five years that are similar in scope, complexity, and magnitude to the work required under this solicitation. These reference projects must demonstrate the contractor's successful ability to accomplish projects in a timely and satisfactory manner.
The form requires contractors to identify whether they are submitting as a prime contractor or subcontractor and to provide detailed information for each reference project, including project name and location, description of work, identification of prime and subcontractors, percentage of work performed by each party, original and actual completion dates, initial and final contract amounts, point of contact information, and any problems encountered with corrective actions taken. If an offeror intends to utilize subcontractors for major components of work, all requested information must be provided for each proposed subcontractor as well. The form provides space for three separate project references on the two-page template.
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Text version
Solicitation No: 140L3625R0012 PROJECT DESCRIPTION: GAOA Chain of Lakes Potable Water System Replacement
REFERENCE LIST
The contractor shall furnish a list (no more than three) 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: 140L3625R0012 PROJECT DESCRIPTION: GAOA Chain of Lakes Potable Water System Replacement
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: ________________________________________________
| REFERENCE LIST |
| CONTRACTOR NAME: _____________________________________________________________________ |
| Prime Contractor |
| CONT RACT OR NAM E: |
| Pri m e Con tracto r: Off |
| Subcontractor: Off |
| 1 Nam e and Location of Proj ect: |
| Prime Contractor: |
| Subcontractors: |
| Percentage of Work Performed by Prime: |
| of Work Performed by Subcontractors: |
| 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 Nam e and Location of Proj ect: |
| Prime Contractor_2: |
| Subcontractors_2: |
| Percentage of Work Performed by Prime_2: |
| of Work Performed by Subcontractors_2: |
| Original Completion Date_2: |
| Actual Completion Date_2: |
| Initial Contract Amount_2: |
| Final Contract Amount_2: |
| Name Address and Phone Number of Point of Contact_2: |
| Problems Encountered and Corrective Actions Taken_2: |
| 1: |
| 3 Name and Location of Project: |
| Prime Contractor_3: |
| Subcontractors_3: |
| Percentage of Work Performed by Prime_3: |
| of Work Performed by Subcontractors_3: |
| Original Completion Date_3: |
| Actual Completion Date_3: |
| Initial Contract Amount_3: |
| Final Contract Amount_3: |
| Name Address and Phone Number of Point of Contact 1: |
| Name Address and Phone Number of Point of Contact 2: |
| Problems Encountered and Corrective Actions Taken 1: |
| Problems Encountered and Corrective Actions Taken 2: |
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