B01 Attachment J04 Company Specialized Experience Form Construction.pdf

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Attached to
Duplex Construction at Pine Ridge, Kyle, and Wanblee Federal contract opportunity
Solicitation number
75H70125R00064
Issued by
Department of Health and Human Services Indian Health Service

About this file

This is a Company Specialized Experience Construction Form (Attachment J04) for solicitation number 75H70125R00064, designed to collect information about contractors' relevant construction project experience within the last six years. The form requires companies to demonstrate experience with projects of similar scope and complexity to the solicited work by providing detailed information about past construction projects.

The form requests comprehensive project details including: type and name of project, location, owner, general scope of construction, facility type (office building, hospital, etc.), building size in gross square feet and number of stories, the company's role (prime contractor, joint venture, or subcontractor), self-performed work, contract dollar value, subcontracted work details, construction timeline with start/completion dates and percentage completed, and owner performance evaluations. Additional information required includes whether the company was terminated or assessed liquidated damages (with explanation if applicable) and owner reference contact information with current telephone numbers. Companies must use one form per project to document their specialized construction experience for evaluation under Volume II - Factor 2 - Specialized Experience of the solicitation response.

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Text version

Volume II – Factor 2 – Specialized Experience

FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)

Response to Solicitation 75H70125R00064

Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H70125R00064

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: 75H70125R00064

Volume II – Factor 2 – Specialized Experience

FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)

Response to Solicitation 75H70125R00064

(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 .