EXHIBIT A - Statement of Prior Experience UD Reno 6E 48 Hour Observation.pdf

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Attached to
Z1DA--646-24-1-5669-0001 | NRM| 646-19-103 UD Reno 6E 48 Hour Observation (VA-24-00003800)
Solicitation number
36C24423R0148
Issued by

About this file

This document contains an exhibit template for a federal construction contract opportunity. The template requests information on offerors' prior experience, including details of up to two relevant projects completed within the past five years. It also requests information on major subcontractors to be used, including the scope of work and examples of two joint projects with each subcontractor in the past five years. The related federal opportunity is for 48-hour observation services at a VA medical center in Reno, Nevada, with a solicitation number of 36C24423R0148 and opportunity number of Z1DA--646-24-1-5669-0001. The contracting agency is the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4.

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PART 1 – RELEVANT PRIOR PROJECT EXPERIENCE

Prime Contractors prepare no more than two (2) Part 1 forms for submission. Subcontractors may prepare up to one (1) Part 1 form for submission by the Prime. Prime Contractor submit up to three (3) total Part 1 forms from your team. Offeror cannot be a POC below nor a reference in Exhibit B for a Subcontractor on their team.

Provide the information requested below in this format for one project/contract being described. Describe a project that contributes relevant experience and knowledge to your firm, considering the project being solicited. Use a separate form for each project/contract being described. Projects may be ongoing and cannot have been completed greater than 5 years prior to the solicitation issue date. Provide frank, concise comments regarding YOUR

FIRM’S experience and knowledge gained on the contracts you present. Utilize this form or reproduce the format of this Exhibit. Each Part 1 form response is limited to four (4) pages in this format.

A. Your Company Name:

B. Submitting as: Prime (Offering) or Sub Contractor (check one).

C. Name of Project/Contract being described:

D. Contract Details:

1. Briefly describe scope of work provided/performed as Prime or Sub

Contractor (check one and state trade if Subcontractor). Provide details in section E below.

2. Contract Number:

3. Contract Type:

4. Original Contract $ Value:

5. Current/Final Contract $ Value:

6. If the $ Values in C.4 and C.5 above are not equal, provide a brief description of the reason(s) for the difference, including contract Modifications:

7. Approximate project area in square feet:

8. Completion Date (full contract close-out):

a. Original Contract Completion Date:

b. Current Percent Complete:

c. Estimated/Actual Completion Date:

d. Explain the primary cause for any Schedule modifications:

E. Details of work performed on the contract being described.

1. Provide a detailed description of the work performed directly by your firm and its present employees under the contract.

2. Describe why you believe the work your firm performed is Very Relevant, Relevant or

Semi-Relevant to the solicited project.

3. (For Prime Contractors) Indicate what elements of work were performed by your major subcontractors, the names of those subcontractors, and indicate whether those subcontractors will be used on the project to be awarded under this solicitation.

F. Points of Contact (POC) for the project’s Owner/Government Agency (or Prime Contractor if Subcontractor is completing form): Contracting Officer, COR, Project Manager, Inspector, FMS Supervisor, etc. Include Agency/Owner/Contractor name, POC name, title, current phone number and email address for each, up to two.

1.

2.

End of Part 1 – Relevant Prior Project Experience – Prepare and send Exhibit E – Past

Performance Questionnaire (PPQ) to each of the reference contact(s) for each of the no more than four (4) total Construction Projects submitted under Exhibit A, Part 1.

See below for Exhibit A, Part 2.

PART 2 – JOINT EXPERIENCE WITH MAJOR SUBCONTRACTORS

Prime Contractors (only) complete one (1) Part 2 form to identify your primary Subcontractors for the project being solicited, and to highlight your joint project experience with them.

A. On the following pages, name major Subcontractors and/or Teaming Partners to be utilized on the contract being solicited. Describe the principle and mutually exclusive scopes of work each Subcontractor in each major trade will perform on the solicited project. As a minimum, provide the name(s) of subcontractor(s) to be utilized for the one (1) major specialty trade indicated in the form below. Up to one (1) additional subcontracted trade or Teaming Partner may be included on the form. For each

Subcontractor or Teaming Partner indicated, list up to two (2) previous or current projects worked on with that party in the past five (5) years and provide the additional data requested below. Offerors are required to have each Subcontractor or

Teaming Partner named in Exhibit A, Part 2 complete a Subcontractor Consent and

Reference Form (Exhibit B), submitted by Offeror.

Begin on the next page. Each trade described shall utilize one page, up to two trades total.

1. Trade: HVAC Systems

a. HVAC Subcontractor:

1) Number of Projects teamed with this Prime Contractor in the past five

(5) years:

2) Principle scope of work to be performed by Subcontractor:

3) Recent projects performed jointly with Subcontractor/Partner:

Project

Name

Owner /

Contact name/

Phone/

Email

Contract completion date or ongoing

Approx. size, SF

Final total project

$ Value

Percent $ Value by

Subcontractor/Partner

Brief scope of work performed by

Subcontractor

2. Trade:

a. Subcontractor:

1) Number of Projects teamed with this Prime Contractor in the past five

(5) years:

2) Principle scope of work to be performed by Subcontractor:

3) Recent projects performed jointly with Subcontractor/Partner:

Project

Name

Owner /

Contact name/

Phone/

Email

Contract completion date or ongoing

Approx. size, SF

Final total project

$ Value

Percent $ Value by

Subcontractor/Partner

Brief scope of work performed by

Subcontractor

End of Part 2 – Joint Experience with Major Subcontractors

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