Format_For_Submission_Experience_(3).pdf

Format For Submission of Recent/Relevant Experience (To be completed by Prospective Contractor)

1. Contractor (Firm being evaluated):

Name:

Address:

3. Contract Number:

4. Contract Dollar Value:

5. Month/Year Awarded:

Routine → Difficult

2. Complexity of Work 1 2 3 4 5

6. Contract Status:

Active Complete

7.Completion Date (w/ extensions):

8. Description, location & relevancy of work:

9. Specifically address the role, degree of involvement and responsibility, and range of duties performed by the proposed key personnel for this acquisition in the projects selected to demonstrate the proposed experience.

10. Problems encountered and how resolved:

11. Name, Address, Telephone Number and E-mail of the Procuring Contracting Officer and/or the

Contracting Officer’s Representative (COR) (and other references, e.g., Administrative Contracting

Officer, if applicable):