B01 Attachment J04 Company Specialized Experience Form Construction.pdf
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- Attached to
- Stephenson-Taylor Water Line Extension
- Solicitation number
- 75H70125R00054
About this file
The document is an Attachment J04 Company Specialized Experience – Construction Form for Solicitation 75H70125R00054, designed to capture detailed information about a company's previous construction project experience. The form requires contractors to provide comprehensive project details including project type, company name, project name, location, owner, general scope, facility type, building size, company role, contract value, subcontracted work, construction dates, performance evaluation, termination history, and reference contact information. This form is part of the Indian Health Service's solicitation for the Stephenson-Taylor Water Line Extension project, which seeks to construct approximately 2,500 feet of 4-inch HDPE water line and 8,300 feet of 4-inch PVC water line in Binger, Oklahoma, with a project duration of 90 calendar days and an estimated contract value between $250,000 and $500,000.
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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 75H70125R00054
Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H70125R00054
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: 75H70125R00054
Volume I – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H70125R00054
(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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