Attachment J Experience Information Sheet.docx
DOCX document 22 KB Posted
- Solicitation number
- 36C24822R0002
About this file
This document contains details for a federal contract opportunity to replace variable air volume assemblies at the West Palm Beach Veterans Affairs Medical Center. The Department of Veterans Affairs Network Contracting Office will issue a solicitation on or around October 28, 2021 for a firm-fixed-price contract between $10-20 million to provide labor, tools, materials and equipment to replace approximately 1,184 variable air volume boxes in the main hospital and 119 variable air volume boxes in the community living center. Interested contractors must be registered in the System for Award Management and respond by December 2, 2021. The opportunity is set aside for service-disabled veteran-owned small businesses. The selected contractor will perform the work at the West Palm Beach Veterans Affairs Medical Center located at 7305 N. Military Trail, West Palm Beach, Florida.
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EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 1 Must have a total of four (4) projects, more than 4 will not be evaluated; less than 4 may result in a lower rating.
a. Contractor Information of Awarded Contract (Firm Name, Address, DUNS Number, Phone number, POC Name, POC e-mail, Company e-mail)
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 or Subcontractor
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).
EXPERIENCE
INFORMATION
SHEET
36C2482 2R0002
| EXPERIENCE INFORMATION SHEET | |
| 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 page for additional information, if necessary.
| EXPERIENCE INFORMATION SHEET | |
| PROJECT NO. [ | ] Page 3 |
i. Describe any difficulties and/or obstacles encountered during project performance; steps taken toward resolution
j. Describe differing site condition(s) occurrence(s) 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 (mm/dd/yyyy): |
| Original completion date (mm/dd/yyyy): |
l. Actual Completion Date (mm/dd/yyyy), and if not completed, why?
Actual Completion Date:
m. Attesting the example project is 100% complete? YES [ ]
n. The Offerors shall indicate if any of the example project provided was 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:
PROJECT NO. [ ] Page 4
CONTINUATION PAGE:
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