B01 Attachment 06 - Company Specialized Experience Form.docx
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- Solicitation number
- 75H701-20-R-00032
About this file
This document is a template form for companies to provide information on previous relevant project experience to qualify for a federal contract solicitation. The solicitation is to provide construction services for a 6-inch PVC water main and associated appurtenances, as well as new pumphouse piping and plumbing, on the Mescalero Apache Reservation in New Mexico. Companies should use the form to describe up to seven years of past similar project experience, including construction cost, scope of self-performed and subcontracted work, performance references, and any project terminations or liquidated damages assessed. The required response is for Solicitation Number 75H701-20-R-00032 from the Department of Health and Human Services Indian Health Service to construct the well connection and water main extension project on the Mescalero Apache Reservation.
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Text version
16-161-SOL-00001
NCYRTC
Attachment 06 - Company Specialized Experience Form Solicitation 75H701-20-R-00032
COMPANY SPECIALIZED EXPERIENCE 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 Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed :
Construction Cost 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 I – Factor 1 –Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H701-20-R-00032
File details come from the government source that posted it. Updated .