ATTACHMENT I - Experience Information Form.pdf
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- Solicitation number
- 36C24822R0093
About this file
This solicitation requests proposals for design-build services for police upgrades at two Department of Veterans Affairs outpatient clinics. Interested firms must have current System for Award Management and Vet-Biz certifications as a Service-Disabled Veteran-Owned Small Business. The project scope involves all design and construction labor to upgrade security at the Viera and Lake Baldwin OPCs. The period of performance is 292 calendar days from notice to proceed. Evaluation will use a two-phase design-build selection and tradeoff process. The estimated value is between $250,000 and $500,000. Proposals are due by the date specified in solicitation number 36C24822R0093. The contracting office point of contact is Elizabeth Romero.
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EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 1
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).
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
ATTACHMENT F {3 PAGES}
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:
ATTACHMENT F {3 PAGES}
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