B01 Attachment J06 - Company Specialized Experience Form.pdf
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- Lawton Indian Hospital Emergency Department, Imaging Services & Laboratory Expansion & Renovation
- Solicitation number
- 75H701-23-R-00014
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Attachment J06 - Company Specialized Experience Form Solicitation 75H701-23-R-00014
Volume I – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H701-23-R-00014
COMPANY SPECIALIZED EXPERIENCE FORM
Provide the following information to show examples of projects your company constructed that are at least 75% complete or completed within the last seven (7) years indicating experience with projects of similar type and scope. 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) Construction Cost
(g) Scope of Construction Project (Describe scope and relevancy to instant requirement)
(h) Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed:
(i) Extent and Type of Work Subcontracted Out
(j) Dates Construction: Began___________________ Completed______________ % Completed _______
(k) Your Performance Evaluation by Owner, if known
(l) Were You Terminated or Assessed Liquidated Damages?
(If either is “Yes”, attach an Explanation)
(m) Owner’s Point of Contact for Reference (Name and Company)
(n) Current Telephone Number of Reference POC
COMPANY SPECIALIZED EXPERIENCE FORM
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