Attachment J Specialized Experience Form.docx
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- Solicitation number
- 75H701-24-R-00010
About this file
This document is a specialized experience form required as part of the response to solicitation number 75H701-24-R-00010 for the Winslow and Dilkon Health Care Facility Demolition/Abatement project issued by the Department of Health and Human Services Indian Health Service. Respondents must use the form to provide details of up to three relevant construction projects completed within the last seven years, including the type and size of facilities, dollar value, the respondent's role, subcontracting details, performance references, and liquidated damages assessments. The form requests specifics such as location, owner, general scope of work, whether the company was prime contractor or subcontractor, percentage of work self-performed, amounts subcontracted, start and completion dates, and reference contact information.
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Text version
16-161-SOL-00001
NCYRTC
Attachment J- Company Specialized Experience – Construction Form Solicitation Number: 75H70124R00010
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
Provide the following information to show examples of projects your company constructed within the last seven (7) years indicating experience with projects of similar type and scope. Use one form per project.
Type of Project Represented Your Firm’s Name Name of Project Location of Project Owner General Scope of Construction Project Type of Facility (i.e. office building, hospital, etc.)
Size of building, including number of gross square feet and number of stories Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed Dollar Value of the Contract Extent and Type of Work Subcontracted Out Dates Construction: Began___________________ Completed______________ % Completed _______ Your Performance Evaluation by Owner, if known
Were You Terminated or Assessed Liquidated Damages?
(If either is “Yes”, attach an Explanation) Owner’s Point of Contact for Reference (Name and Company) Current Telephone Number of Reference POC
SOURCE SELECTION SENSITIVE For Official Use Only Volume 2 – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H70124R00010
File details come from the government source that posted it. Updated .