B01 Att J07 - Company Specialized Experience Form Construction.pdf
PDF 181 KB Posted
- Attached to
- Blackfeet Apartment Complex, Browning MT Federal contract opportunity
- Solicitation number
- 22R00068
About this file
This document contains a template form for companies to provide information on specialized construction experience relevant to federal contracting opportunities. The form requests details on up to five projects completed in the last five years, including the type of project, the company and project names, locations, owners, general scopes of work, the company's role and self-performed work, construction costs, subcontracted work, dates, performance evaluations, terminations or liquidated damages assessments, and references.
The related federal contracting opportunity is a solicitation for the construction of the Blackfeet Apartment Complex in Browning, Montana issued by the Department of Health and Human Services Indian Health Service. Companies are to use the construction experience template form to demonstrate relevant past performance for this contracting opportunity to build an apartment complex on the Blackfeet reservation.
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Text version
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Attachment J05. Company Specialized Experience – Construction Form
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
Provide the following information to show examples of projects your company constructed within the last five (5) years indicating experience with projects of similar type and scope. Use one form per project.
(a) Type of Project Represented
(b) Your Firm’s Name
(c) Name of Project
(d) Location of Project
(e) Owner
(f) General Scope of Construction Project
(g) Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed :
(h) Construction Cost
(i) Extent and Type of Work Subcontracted Out
(j) Dates Construction: Began___________________ Completed______________ % Completed _______
(k) Your Performance Evaluation by Owner, if known
(l) Were You Terminated or Assessed Liquidated Damages?
(If either is “Yes”, attach an Explanation)
(m) Owner’s Point of Contact for Reference (Name and Company)
(n) Current Telephone Number of Reference POC
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
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