J.18 Relevant Experience Project Template JUN2021.docx
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UNCLASSIFIED
HM0476-21-R-0023 Section J, Attachment 18 Relevant Work Experience WSC Project Template
(U) HM0476-21-R-0023
(U) Section J Attachment 18
(U) National Geospatial-Intelligence Agency (NGA)
CLOVER
(EMERALD FOLLOW-ON)
(U) Relevant Work Experience Work Service Category (WSC) Project Template
(U) June 3, 2021
(U) Version 1
Attachment J.18 Relevant Experience (Work Service Category) Project Template
Instructions: Complete and submit this form for each WSC Project referenced in VOLUME 2 – RELEVANT EXPERIENCE of Attachment J.17 Self-Scoring Sheet. Maximum of 9 submissions.
Part I. Project Identification – Provide the information below for each WSC Project referenced under VOLUME 2 – RELEVANT EXPERIENCE of Attachment J.17 Self-Scoring Sheet. For Work Service Category, choose the CLOVER WSC that correlates to the work performed.
| Contractor Name: |
| Enter Contractor Name |
| Contract Number: |
| Enter Contract Number |
| Order Number (if applicable): |
| Enter Order Number |
| Project Title: |
| Enter Project Title |
| Project Value: |
| Enter Project Value |
| Work Service Category: |
| Choose a WSC |
| Self-Scoring Sheet Reference: |
| Choose a WSC Project |
| Prime (non-JV), Subcontractor, JV: |
| Prime (non-JV) ☐, Subcontractor ☐, JV ☐ |
| Prime POC information (if worked performed as subcontractor): |
| Enter Name, Email, & Phone # |
| Total Period of Performance, Including Options: (MM/YYYY – MM/YYYY or MM/YYYY – Present) |
| MM/YYYY – MM/YYYY |
Part II. Project Reference Information – Please provide the Contracting Officer (CO) or Contracting Officer Representative (COR) information below.
Contracting Officer (or Corporate Official for Commercial Experience)
| Name: |
| Enter Name |
| Title: |
| Enter Title |
| Agency or Customer: |
| Enter Agency or Customer |
| Phone: |
| Enter Phone |
| Email: |
| Enter Email |
Contracting Officer’s Representative (Complete only if COR providing signature verification in Part IV)
| Name: |
| Enter Name |
| Title: |
| Enter Title |
| Agency or Customer: |
| Enter Agency or Customer |
| Phone: |
| Enter Phone |
| Email: |
| Enter Email |
Part III. Project Description – Describe how the selected Work Service Category (WSC) was integral to the performance of the project. The Offeror must also provide an index to those specific written passes in the SOW that support the claim of having performed the WSC.
Part IV. Signature below by a Contracting Officer, Contracting Officer’s Representative (COR), or Corporate Official for the ordering activity constitutes acceptance of the above project information to be accurate as ordered and received by the listed entity. Signature by COR must include copy of email notification to the cognizant Contracting Officer.
Name: Enter Name Date: Enter a date Signature:
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