B01 RFP Attachment J04 Company Specialized Experience Construction Form.pdf

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Attached to
Belcourt Heat Exchanger Replacement & Boiler System Repairs
Solicitation number
75H70126R00022
Issued by

About this file

This is a Company Specialized Experience – Construction Form template used for federal contract solicitation 75H701-26-R-00022. Bidders must complete one form per project to demonstrate construction experience within the last six years on projects of similar type and scope. The form requires documentation of project details including type of project, firm name, project name, location, owner, general scope of work, facility type, building size in gross square feet and number of stories, and the company's role as prime contractor, joint venture partner, or subcontractor with specific work self-performed.

Additional required information includes the dollar value of the contract, extent and type of subcontracted work, construction dates (begin, completion, and percentage completed), the company's performance evaluation by the owner, whether the firm experienced termination or liquidated damages (with required explanation if applicable), and owner reference contact information including name, company, and current telephone number. This form serves as supporting documentation for Volume II – Factor 1 (Specialized Experience) evaluation and is classified as source selection information under FAR 3.104.

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Volume II – Factor 1 – Specialized Experience

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

Response to Solicitation 75H701-26-R-00022

Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H701-26-R-00022

COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM

Provide the following information to show examples of projects your company constructed within the last six (6) 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) General Scope of Construction Project

(g) Type of Facility (i.e. office building, hospital, etc.)

(h) Size of building, including number of gross square feet and number of stories

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

(j) Dollar Value of the Contract

(k) Extent and Type of Work Subcontracted Out

(l) Dates Construction: Began___________________ Completed______________ % Completed _______

(m) Your Performance Evaluation by Owner, if known

Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H701-26-R-00022

Volume II – Factor 1 – Specialized Experience

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

Response to Solicitation 75H701-26-R-00022

(n) Were You Terminated or Assessed Liquidated Damages?

(If either is “Yes”, attach an Explanation)

(o) Owner’s Point of Contact for Reference (Name and Company)

(p) Current Telephone Number of Reference POC

COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM

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