Attachment J07 - Key Personnel Resume Form.pdf

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Fort Washakie Optometry & HIM Remodel
Solicitation number
75H70123R00061
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This solicitation notice is for construction services for the Fort Washakie Optometry & HIM Remodel project located at the Wind River Service Unit in Fort Washakie, Wyoming. The scope of work involves renovating approximately 3,661 total square feet of the existing Optometry and Medical Records departments to improve patient access to care. Drawings and specifications are provided in attachments to the solicitation. The construction magnitude is estimated between $1,000,000 to $5,000,000. The period of performance is 300 calendar days from notice to proceed. A pre-bid site visit will take place on June 14, 2023 at 10:00 AM MDT. The Indian Health Service intends to award a firm fixed price contract under a request for proposal evaluated with lowest price technically acceptable criteria. The North American Industry Classification System code is 236220 and the size standard is $45 million. Responses are due by the date and time specified in the solicitation. The contracting agency is the Department of Health and Human Services Indian Health Service.

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Volume 1 – Factor 2 – Key Personnel

FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)

Response to Solicitation 75H701-23-R-00061

Attachment J07. Key Personnel Resume Form Solicitation 75H701-23-R-00061

KEY PERSONNEL RESUME FORM

Provide information, listed below, on separate sheets showing qualifications of:

1) Prime Contractor’s Project Manager

2) Project Site Superintendent

3) Safety Officer

Use a continuation sheet, if needed.

(a) Your Name and Title

(b) Your Assignment on this Project

(c) Name of Your Firm

(d) No. of Years: With this Firm__________ With other Firms____________

(e) Education: Degree(s)/Year/Specialization

(f) Active Registration, if any: No._______, State(s) ______, First Year/ Current Year ______/______

(g) Type of Registration __________________________ (P.E., R.A., LEED-AP, etc.)

(h) Describe Your Specific Experience and Qualifications Relevant to this Project:

Attachment J07. Key Personnel Resume Form Solicitation 75H701-23-R-00061

Volume 1 – Factor 2 – Key Personnel

FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)

Response to Solicitation 75H701-23-R-00061

KEY PERSONNEL RESUME
____________________________________________________________________________________

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