J04 Company Specialized Experience Construction Form.docx
DOCX document 21 KB Posted
- Attached to
- TPPIHC Roof Replacement and Fall Protection
- Solicitation number
- 75H70125R00037
About this file
This is a company specialized experience form (Attachment J04) that offerors must complete to demonstrate their relevant construction experience for solicitation 75H701-25-R-00037, the Taos-Picuris Roof Replacement and Fall Protection project. The form requires details about construction projects completed within the last 6 years, including project type, location, scope, facility type, building size, role (prime/sub), contract value, subcontracted work, performance dates, owner evaluations, and reference contact information.
The related solicitation is for roof replacement and fall protection at the Taos-Picuris Pueblos Indian Health Center in Taos, New Mexico. This is a 100% Indian Small Business Economic Enterprise set-aside under NAICS 238160 (Roofing Contractors) with an estimated value between $1-5 million. The Indian Health Service will award a single Firm Fixed Price contract with a 180-day period of performance, using Lowest Price Technically Acceptable evaluation criteria. Small business size standard is $19 million average annual revenue over 5 years.
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Text version
16-161-SOL-00001
NCYRTC
Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H701-25-R-00037
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
Provide the following information to show examples of projects your company constructed within the last six (6) years indicating experience with projects of similar type and scope. Use one form per project.
Type of Project Represented Your Firm’s Name Name of Project Location of Project Owner General Scope of Construction Project Type of Facility (i.e. office building, hospital, etc.)
Size of building, including number of gross square feet and number of stories Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed Dollar Value of the Contract Extent and Type of Work Subcontracted Out Dates Construction: Began___________________ Completed______________ % Completed _______ Your Performance Evaluation by Owner, if known
Were You Terminated or Assessed Liquidated Damages?
(If either is “Yes”, attach an Explanation) Owner’s Point of Contact for Reference (Name and Company) Current Telephone Number of Reference POC
SOURCE SELECTION SENSITIVE For Official Use Only Volume I – Factor 1 – Specialized Experience
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
Response to Solicitation 75H701-24-R-00020
File details come from the government source that posted it. Updated .