J-1 Corporate Experience Project Data Sheet.docx

N62470-22-R-9000 CNIC Housing Condition Assessment Program (HCAP)

ATTACHMENT J-1

CORPORATE EXPERIENCE PROJECT DATA SHEET

Project No. (check one) : |_| #1 |_| #2 |_| #3

1. Experience for: |_| Offeror for this Solicitation |_| Other (Identify below, e.g.: JV Member, Subcontractor, Corporate affiliate, etc.)

Name of entity that performed services for this Project: ____________________________________________ Entity CAGE: _____________ Entity DUNS: _____________ Address:

Phone Number:

Point of Contact: Contact Phone Number:

Percent of project work performed by entity listed in Box 1:

If other than Prime, 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. Provide the dollar amount of work completed for each full year of performance within the recency period: (Expand as appropriate and provide each full year as a separate period of performance)

Period of Performance #___ (______ to ______): $__________ (for this period)

6. Type of Contract/Task Order: (Check ALL that apply)

|_| Firm-Fixed Price |_| Cost/Time and Material |_| Other (explain):___________________

7. Type of Contract/Task Order: (Check ALL that apply)

|_| Standalone Contract |_| Single Delivery/Task Order |_| Indefinite Delivery/Indefinite Quantity

|_| Other (explain): ____________________________________________________________________

8. Provide a detailed description of the project and the relevancy to the project requirements of this Solicitation.

9. Provide a detailed description of what work the entity listed in Box 1 self-performed on this project:

10. Other Information:

SOURCE SELECTION SENSITIVE INFORMATION

DISCLOSURE LIMITATIONS AS OUTLINED IN FAR 2.101 & 3.104 APPLY