Attachment_3_-_Specialized_Experience_Form_Design.pdf

FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)

Attachment 3 Company Specialized Experience – Design Firm or In-House Design Capability

Section 1 – Factor 1 – Specialized Experience Response to Phase I Solicitation HHSI02-19-R-00017

While this exact form is not required, the same information must be provided. Provide the following information to show examples of projects your company designed within the last seven (7) years and that are at least 75% complete as of the date of Phase I proposal submission indicating experience with projects of similar type and scope. Use one form per project.

(a) Type of Project Represented

(b) Your Firm’s Name

(c) Name of Project

(d) Location of Project

(e) Owner ________________________________________________________________________________

(f) General Scope of Construction Project

(g) Summary of Your Role in Design of this Project

(h) Identify Estimated (“E”) or Actual (“A”) Construction Cost

(i) Extent and Type of Work You Subcontracted

(j) Dates Design: Began___________________ Completed______________

(k) Dates Construction: Began___________________ Completed______________

(l) Your Performance Evaluation, if known

(m) Were You Terminated or Assessed Liquidated Damages?

(If either is “Yes”, attach an Explanation)

(n) Owner’s Point of Contact for Reference (Name and Company)

(o) Current Telephone Number of Reference POC