B08_Attachment_6_-_Experience_Form.docx

DOCX document 22 KB Posted

Attached to
NATIONAL PARK SERVICE - NATIONAL CAPITAL AREA - MO
Solicitation number
140P3023R0011
Issued by

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This document is an experience form for solicitation number 140P3023R0011 related to rehabilitating the Thomas House geothermal piping at Monocacy National Battlefield for the National Park Service National Capital Area. Offerors must complete the form to detail up to five prior, relevant projects for evaluation purposes, including contract/project numbers, locations, original and final contract amounts, client/agency points of contact and their contact information, original and completion project dates, whether the offeror served as a prime contractor or subcontractor, whether contract modifications occurred and details thereof, whether time extensions were granted and new completion dates, and whether schedules were met or reasons for delays. Offerors must also disclose whether they have entered disputes or been defaulted on contracts previously and reasons for such occurrences.

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SOLICITATION No. 140P3023R0011

EXPERIENCE FORM (Offerors must complete this form for evaluation puposes)

NAME OF FIRM
POINT OF CONTACT

TELEPHONE NO.

FAX NO.

PRIOR PROJECT EXPERIENCE

(TO BE COMPLETED BY THE OFFEROR - LIST UP TO FIVE (5) INDIVIDUAL PROJECTS)

PROJECT DESCRIPTION

(USE BLANK PAGE IF NECESSARY)

CONTRACT/PROJECT NO.
LOCATION
CONTRACT AMOUNT (ROUND TO NEAREST DOLLAR)
ORIGINAL
FINAL

1.

$
$

2.

$
$

3.

$
$

4.

$
$

5.

$
$

NAME OF CLIENT/AGENCY

POINT OF CONTACT

TELEPHONE NO.

FACSIMILE NO.

ORIGINAL PROJECT DATES
WERE YOU A PRIME CONTRACTOR OR SUBCONTRACTOR?
WERE THERE CONTRACT MODIFICATIONS? (YES/NO)
HOW MANY?
WHO INITIATED THEM? CLIENT, CONTRACTOR OR BOTH?
START
COMPLETION

WERE THERE ANY TIME EXTENSIONS? (YES/NO)

IF SO, INDICATE NEW COMPLETION DATE?
WAS THE SCHEDULE MET?

(YES/NO)

IF NOT, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

HAVE YOU EVER ENTERED INTO A DISPUTE? (YES/NO)
IF SO, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

HAVE YOU EVER

BEEN DEFAULTED?

(YES/NO)

IF SO, WHAT WAS THE REASON?

(USE BLANK PAGE IF NECESSARY)

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