B01 Attachment J05 - Company Specialized Experience Form Construction.docx
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- Attached to
- Town of Red Rock Water Main Replacement
- Solicitation number
- 75H70123R00071
About this file
This document is a template form for companies to provide information on specialized construction experience relevant to the requirements of solicitation number 75H70123R00071 issued by the Department of Health and Human Services Indian Health Service. Companies are to fill out one form for each project example within the last seven years demonstrating experience with similar type and scope of construction as the Town of Red Rock Water Main Replacement project. For each project example, companies must provide details such as the type and size of facility, dollar value, subcontracting breakdown, performance evaluation if known, and reference contact information.
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Text version
16-161-SOL-00001
NCYRTC
Attachment J05 - Company Specialized Experience – Construction Form Solicitation Number: 75H70123R00071
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION 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 Type of Facility (i.e. office building, hospital, etc.)
Size of building, including number of gross square feet and number of stories Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed Dollar Value of the Contract 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 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H70123R00071
File details come from the government source that posted it. Updated .