B01 Attachment J08 - Company Specialized Experience Form Construction.docx

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Dustin Water Storage Tank Project
Solicitation number
75H70122R00037
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This document contains a solicitation notice for a construction project. The Indian Health Service is seeking proposals to design and construct a 50,000-gallon elevated steel water storage tank and associated piping and valves in Dustin, Oklahoma for between $500,000 to $1,000,000. Interested offerors must visit the site on May 17th, 2022 and register in the System for Award Management (SAM) to be eligible for award. Proposals are due by August 1st, 2022 and the project completion date is 270 calendar days from notice to proceed. The solicitation will utilize lowest price technically acceptable source selection with preference given to verified Indian Economic Enterprises. The contract type will be firm fixed price.

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Other files

File Type Posted
B05 22R00037 Amendment A00001 SF30.pdf PDF
B05 Amendment A00001 Attachment 1 Addendum 1 75H70122R00037 5 20 2022.pdf PDF
B05 Amendment A00001 Attachment 2 - Dustin WST Midco Inspection Report.pdf PDF
B05 Amendment A00001 Attachment 3 - Dustin WST_Paint Analysis_May 2021.pdf PDF
B01 Attachment J03 - DustinPWA_WL210860_Specs.pdf PDF
B01 Attachment J06 - IHS IEE Representation Form.pdf PDF
B01 RFP 75H70122R00037.pdf PDF
B01 Attachment J05 - GeotechlReport.pdf PDF
B01 Attachment J04 - DustinPWA_WL210860_Plans.pdf PDF
B01 Attachment J07 - PPQ.pdf PDF
B01 Attachment J01- Self Perform Calc Sheet - Construction.docx DOCX document
B01 Attachment J02 - WD Hughes County OK.pdf PDF
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16-161-SOL-00001

NCYRTC

Attachment J06- Company Specialized Experience – Construction Form Solicitation 75H701-22-R-00037

COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM

Provide the following information to show examples of projects your company constructed within the last ten (10) 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 – Specialized Experience

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

Response to Solicitation 75H701-22-R-00037

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