B01 Attachment J05 - Company Specialized Experience Form.docx

DOCX document 20 KB Posted

Attached to
Clinton Emergency Generator Federal contract opportunity
Solicitation number
75H70123R00045
Issued by
Department of Health and Human Services Indian Health Service

About this file

This document contains a company specialized experience form and details of a federal contract opportunity for an emergency generator system installation. The company specialized experience form requests details of previous relevant construction projects completed by the firm within the last seven years, including project type and location, construction costs, the firm's role, dates of work, and performance references. The federal contract opportunity is a solicitation from the Department of Health and Human Services Indian Health Service for a $1-5 million project to fully install a 1,200KW emergency generator system and associated work to provide backup power to the Clinton Indian Health Center. The NAICS code is 238210 and it is set aside for small businesses under $19 million in size.

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Text version

16-161-SOL-00001

NCYRTC

Attachment J05. Company Specialized Experience – Construction Form Solicitation 75H70123R00045

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 Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed :

Construction Cost 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 –Experience

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

Response to Solicitation 75H70123R00045

File details come from the government source that posted it. Updated .