B01 Attachment J04 Company Specialized Experience Form Construction.pdf
PDF 728 KB Posted
- Attached to
- BLACKFEET HOSPITAL CT ROOM RENOVATION
- Solicitation number
- 75H70125R00016
About this file
This is a Company Specialized Experience Construction Form (Attachment J04) for solicitation 75H70125R00016, used to gather information about bidders' relevant construction project experience from the past 6 years. The form requests detailed project information including type of project, company name, project name, location, owner, general scope, facility type, building size, role (prime/subcontractor), contract value, subcontracted work, construction dates, performance evaluation, and reference contact information.
The form is part of Factor 1 - Specialized Experience for a construction project at Blackfeet Hospital and includes fields for documenting whether the contractor was terminated or assessed liquidated damages on previous projects. It requires one form to be completed per relevant project demonstrating similar scope and complexity. The form is marked "FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)" and consists of 2 pages with fields (a) through (p) for contractors to complete.
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Text version
Volume I – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H70125R00016
Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H70125R00016
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
Provide the following information to show examples of relevant projects your company constructed within the last six (6) years indicating experience with relevant projects of similar scope and complexity. 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) Type of Facility (i.e. office building, hospital, etc.)
(h) Size of building, including number of gross square feet and number of stories
(i) Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed
(j) Dollar Value of the Contract
(k) Extent and Type of Work Subcontracted Out
(l) Dates Construction: Began___________________ Completed______________ % Completed _______
(m) Your Performance Evaluation by Owner, if known
Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H70125R00016
Volume I – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H70125R00016
(n) Were You Terminated or Assessed Liquidated Damages?
(If either is “Yes”, attach an Explanation)
(o) Owner’s Point of Contact for Reference (Name and Company)
(p) Current Telephone Number of Reference POC
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
File details come from the government source that posted it. Updated .