B01 Attachment J04 Company Specialized Experience Form Construction.pdf
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- Attached to
- Life Safety Updates at Kyle, Wanblee, LaCreek
- Solicitation number
- 75H70125R00052
About this file
The document is an Attachment J04 Company Specialized Experience – Construction Form for the federal contract opportunity Solicitation Number 75H70125R00052. The form requires offerors to provide detailed information about relevant construction projects completed within the last six years, demonstrating their specialized experience. The form captures comprehensive project details including project type, firm name, project name, location, owner, general scope, facility type, building size, company role, contract value, work performed, subcontracted work, construction dates, performance evaluation, termination history, and reference contact information. This form is part of the proposal submission for the Indian Health Service life safety updates project at Kyle, Wanblee, and LaCreek health centers in South Dakota, which is being solicited as a 100% set-aside for Indian Small Business Economic Enterprise under NAICS code 236220 with an estimated project value between $500,000 and $1,000,000.
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Volume I – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H70125R00052
Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H70125R00052
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: 75H70125R00041
Volume I – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H70125R000452
(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
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