Attachment J05 Company Technical Experience Construction Form.docx

This is a construction experience qualification form required as part of a competitive solicitation for heliport and concrete structural remediation work at the Northern Cheyenne Health Center in Lame Deer, Montana. Contractors must complete one form per project to demonstrate relevant construction experience from the past six years.

The form requests detailed information about previously completed projects of similar type and scope, including project identification, location, owner information, general scope, facility type, building size in gross square feet and number of stories, contractor's role (prime, joint venture, or subcontractor), dollar value of contract, extent of subcontracted work, construction timeline with percentage completion status, performance evaluation by the owner, any termination or liquidated damages history, and owner reference contact information with current telephone number. This documentation is required to support the specialized experience evaluation factor in the source selection process for solicitation 75H701-26-R-00019, which involves demolition and replacement of a heliport, structural concrete remediation of ambulance bay and emergency entrance areas, installation of electrical lighting systems, safety improvements, and HVAC work with an anticipated project magnitude between $1,000,000 and $5,000,000 and a 120-calendar-day performance period.