B01 Attachment J08 Company Specialized Experience Form Construction.docx

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Crownpoint Staff Quarters Replacement
Solicitation number
75H7014R00010
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This document is a template form for companies to provide details of relevant past construction projects to qualify for specialized experience consideration for solicitation number 75H701-24-R-00004 from the Department of Health and Human Services Indian Health Service. Companies are to fill in details of one construction project per form, including project name and location, owner information, general scope of work, facility type and size, company's role and self-performed work, dollar value, subcontracted work, dates, performance evaluation if known, and reference contact. The related federal contract opportunity is for the Crownpoint Staff Quarters Replacement project for the Department of Health and Human Services Indian Health Service, solicitation number 75H7014R00010.

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16-161-SOL-00001

NCYRTC

Attachment J08 - Company Specialized Experience – Construction Form Solicitation Number: 75H701-24-R-00004

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 75H701-23-R-00024

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