Attch 7_ Experience.docx

Solicitation FA700018R0011 Attachment #

EXPERIENCE FORM

Offeror’s Name: ________________________________________________________________________

Address: _________________________________________________________________________________

Offeror Point of Contact (POC) Name: ______________________________________________________

Offeror Telephone Number: _______________________________________________________________

Offeror Email:___________________________________________________________________________

Project Title: ________________________________________________________________________

Owner/Customer: ____________________________________________________________________

This project was performed by the named offeror as a (Circle one): Prime Contractor or Subcontractor

Place of Performance: _________________________________________________________________

Contract Number (of single project):______________________________________________________

Contract Value: ______________________________________________________________________

Contract Period or Dates of Performance: _________________________________________________ Project Description:___________________________________________________________________ Was the project performed at an existing site or facility, NOT completely new construction (Circle one): YES or NO Circle types of construction work performed within this project: Electrical work, excavation/earthwork, concrete work, landscaping and/or revegetation, utility work Contract Point of Contact to Verify Above Project Point of Contact: _____________________________________________________________________

Address: ____________________________________________________________________________

Telephone Number: ___________________________________________________________________

Email:_______________________________________________________________________________

***Only one Experience Form will be accepted***