Copy of Attachment A Experience 36C26121R0087.xlsx

XLSX spreadsheet 18 KB Posted

Attached to
Y1DA--NRM: 654-18-807; Water Monitoring and Treatment
Solicitation number
36C26121R0087
Issued by

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This document contains an experience questionnaire for contractors to submit in response to solicitation number 36C26121R0087 for water monitoring and treatment services. The solicitation seeks past project experience information from contractors for up to four previous projects, including title, contract number, dollar amount, description of work performed, construction type, completion status, timeliness, prime contractor status, self performance percentage if a joint venture, and location. The opportunity is issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21 for water monitoring and treatment services. Contractors must demonstrate relevant experience on previous projects performing similar services for the agency.

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FIRM NAME

36C26121R0087 VASNHCS Water Monitoring and Treatment

FACTOR 1 - EXPERIENCE

STATE CONTRACTOR NAME:
Experience - Project 1Title:
Contract #
Project Description
Dollar Amount
Project DescriptionNew construction, Alteration, Repair, ect….
Construction TypeDesign-build / Design Bid Build, ect….
Completed Project?Yes / No
Recent (within five years)?Yes / No
On time?Yes / No
Performed as Prime Contractor?Yes / No
Self-Performance?% of self-performance
Joint Venture?Yes / No
Within VISN 21 Geographic Location?Yes / No
Customer Contact Information
Experience - Project 2Title:
Contract #
Project Description
Dollar Amount
Project DescriptionNew construction, Alteration, Repair, ect….
Construction TypeDesign-build / Design Bid Build, ect….
Completed Project?Yes / No
Recent (within five years)?Yes / No
On time?Yes / No
Performed as Prime Contractor?Yes / No
Self-Performance?% of self-performance
Joint Venture?Yes / No
Within VISN 21 Geographic Location?Yes / No
Customer Contact Information
Experience - Project 3Title:
Contract #
Project Description
Dollar Amount
Project DescriptionNew construction, Alteration, Repair, ect….
Construction TypeDesign-build / Design Bid Build, ect….
Completed Project?Yes / No
Recent (within five years)?Yes / No
On time?Yes / No
Performed as Prime Contractor?Yes / No
Self-Performance?% of self-performance
Joint Venture?Yes / No
Within VISN 21 Geographic Location?Yes / No
Customer Contact Information
Experience - Project 4Title:
Contract #
Project Description
Dollar Amount
Project DescriptionNew construction, Alteration, Repair, ect….
Construction TypeDesign-build / Design Bid Build, ect….
Completed Project?Yes / No
Recent (within five years)?Yes / No
On time?Yes / No
Performed as Prime Contractor?Yes / No
Self-Performance?% of self-performance
Joint Venture?Yes / No
Within VISN 21 Geographic Location?Yes / No
Customer Contact Information

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