B01 RFP Attachment J09 - Company Specialized Experience Form.docx

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Prairie Village Sewer Renovation
Solicitation number
75H70122R00026
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This solicitation is seeking proposals for the Prairie Village Sewer Renovation project. The Indian Health Service is soliciting proposals to furnish all labor, materials, equipment, and services for the renovation of the existing gravity sewer system for the Prairie Village Community located in Anadarko, Oklahoma. The period of performance is 180 calendar days from notice to proceed, and the construction magnitude is estimated between $500,000 to $1,000,000. This will be set aside as a 100% small business opportunity with a preference for Indian Economic Enterprise firms. The contract type will be firm fixed price. The closing date for proposals and additional details are provided in the solicitation.

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16-161-SOL-00001

NCYRTC

Attachment J09 - Company Specialized Experience Form Solicitation 75H701-22-R-00026

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.

Type of Project Represented(b) Your Firm’s Name(c) Name of Project
____________________________________________________________________________________
1. 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 _______

1. 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-00026

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