Attachment 9 Specialized Experience Form.docx

This is a Specialized Experience Form template for construction contractors to demonstrate relevant project experience. The form requires companies to submit examples of projects completed within the last six years that are similar in type and scope to the Grindstone Water Storage Tank Replacement project (Solicitation Number 75H70126R00008). Contractors must provide one form per project, limited to four pages maximum per project, and include comprehensive project details such as project type, location, owner information, facility type, building size in gross square feet and number of stories, the contractor's role (prime, joint venture, or subcontractor), self-performed work scope, contract dollar value, subcontracted work extent and type, performance period or completion percentage, owner performance evaluations, termination or liquidated damages history, and owner reference contact information with current telephone number and email address.

This form is part of Volume II (Factor 1 - Specialized Experience) of the evaluation criteria for the Indian Health Service water infrastructure project in Elk Creek, California. The Grindstone project involves removing two existing water storage tanks, installing electrical control wire in conduit, and adding water monitoring equipment to comply with EPA surface water treatment rule requirements. The procurement is a 100% Indian Small Business Economic Enterprises (ISBEE) set-aside with a firm fixed price contract type, requiring proposals to be submitted electronically by the deadline specified in SF 1442. The construction duration is 180 calendar days following Notice to Proceed, and TERO fees apply to the project.