Attachment Past Experience Form.docx

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Attached to
HVAC Replacement ATCT Jacksonville, FL Federal contract opportunity
Solicitation number
697DCK-21-R-00245
Issued by
Department of Transportation Federal Aviation Administration Southwestern Region

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Attachment # Past Experience Form Please provide all the requested information below. Please note that the references/POCs included in this form may or may not be contacted to verify information at the FAA’s discretion.

Project #1 Name of Project: ________________________________________________ Location of Project: _____________________________________________ Owner/Organization/Customer/Client:____________________ General Scope of Project (HVAC):

Summary of Your Role in this Project:|_| Prime |_|Subcontractor Percent Complete (must be at least 90%) _______________________________ Final Contract Amount (must be at over $50,000)___________________ Were You Terminated or Assessed Liquidated Damages? (if yes, explain) _________________________ Client/Customer Point of Contact Name:__________________________________ Client/Customer POC Phone Number:____________________________________ Client/Customer POC Phone Email:____________________________________

Project #2 Name of Project: ________________________________________________ Location of Project: _____________________________________________ Owner/Organization/Customer/Client:____________________ General Scope of Project (HVAC):

Summary of Your Role in this Project:|_| Prime |_|Subcontractor Percent Complete (must be at least 90%) _______________________________ Final Contract Amount (must be over $50,000)___________________ Were You Terminated or Assessed Liquidated Damages? (if yes, explain) _________________________ Client/Customer Point of Contact Name:__________________________________

Project #3 Name of Project: ________________________________________________ Location of Project: _____________________________________________ Owner/Organization/Customer/Client:____________________ General Scope of Project (HVAC):

Summary of Your Role in this Project:|_| Prime |_|Subcontractor Percent Complete (must be at least 90%) _______________________________ Final Contract Amount (must be over $50,000)___________________ Were You Terminated or Assessed Liquidated Damages? (if yes, explain) _________________________ Client/Customer Point of Contact Name:__________________________________

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