Experience Form.doc
DOC document 87 KB Posted
- Attached to
- Replacement of 34. 5kV feeder underground electrical distribution system Federal contract opportunity
- Solicitation number
- N4008520R2104
About this file
This document contains an experience form template and details of a federal contract opportunity for replacement of an underground electrical distribution system. The experience form is to be completed by offerors and includes details of up to five relevant past construction or design projects, such as award amounts, completion dates, descriptions of work performed, and sustainable or LEED features. The federal contract opportunity is issued by the Naval Facilities Engineering Command to replace the 35kV North Branch underground electrical distribution system at Naval Station Great Lakes with a new 12.47kV system. Work includes feeder cable installation and connections to new pad-mounted transformers, as well as demolition of existing 35kV building feeds. Offerors must complete all work within 365 calendar days of award. The NAICS code is 237130 and product service code is Z2AZ.
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Text version
ATTACHMENT A
CONSTRUCTION & DESIGN EXPERIENCE PROJECT DATA SHEET
Project No. (check one) : FORMCHECKBOX
CON #1 FORMCHECKBOX
CON #2 FORMCHECKBOX
CON #3 FORMCHECKBOX
CON #4 FORMCHECKBOX
CON #5
FORMCHECKBOX
DESIGN #1 FORMCHECKBOX
DESIGN #2 FORMCHECKBOX
DESIGN #3 FORMCHECKBOX
DESIGN #4 FORMCHECKBOX
DESIGN #5
1. Experience for: FORMCHECKBOX Offeror FORMCHECKBOX Joint-Venture FORMCHECKBOX Other (Explain) Firm Name:
Address:
Phone Number:
DUNS Number:
Point of Contact: Contact Phone Number:
2. Work Performed as: FORMCHECKBOX Prime Contractor FORMCHECKBOX Sub Contractor FORMCHECKBOX Joint Venture FORMCHECKBOX Other (Explain) Percent of project work performed:
If subcontractor, who was prime (Name/Phone #):
3. Contract Number: Delivery/Task Order Number:
Title:
Location:
4. Award Date (mm/dd/yy): Completion Date (mm/dd/yy):
5. Type of work:
FORMCHECKBOX
New Construction FORMCHECKBOX Renovation FORMCHECKBOX Repair FORMCHECKBOX Alteration FORMCHECKBOX Other (explain):
6. Type of Contract/Task Order: (Check ALL that apply)
Firm-Fixed Price FORMCHECKBOX Cost/Time and Material FORMCHECKBOX
Complete Block 7 for Construction Projects. Complete Block 8 for Design Projects.
7. Construction Project:
Award Amount: Final Price:
Type of Contract/Task Order: (Check ALL that apply)
FORMCHECKBOX
Design-Build FORMCHECKBOX Design-Bid-Build FORMCHECKBOX Delivery/Task Order (IDIQ) FORMCHECKBOX
If Design-Build, identify the Lead Design Firm:______________________________________________
8. Design Project:
A/E Design Fee: Total Construction Value:
Type of Contract/Task Order: (Check ALL that apply)
FORMCHECKBOX
Design-Build FORMCHECKBOX RFP Development FORMCHECKBOX Designer of Record FORMCHECKBOX Engineering Services FORMCHECKBOX Full Plans & Specs
9. Provide a detailed description of the project and the relevancy to the project requirements of this RFP (i.e.: unique features, square footage, construction methods), including any sustainable features or USGBC LEED certifications. If design-build, include a description of the design-effort.
10. Provide a detailed description of what work your firm self-performed on this project:
11. Other Information:
PAGE
Attachment A (10-02-12)
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