J05 Company Specialized Experience Construction Form.docx
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- Solicitation number
- 75H70126R00010
About this file
The document is a Company Specialized Experience - Construction Form template for a federal solicitation related to the Gallup Indian Medical Center (GIMC) Fire Alarm Upgrade project. The form is designed for contractors to demonstrate their construction experience by providing detailed information about previous projects, including project type, location, owner, scope, facility type, building size, contract value, role, performance dates, and reference contact information.
The associated federal contract opportunity is a 100% Indian Small Business Economic Enterprise (ISBEE) set-aside solicitation under NAICS code 236220 for the Indian Health Service (IHS). The project involves redesigning and installing a fire alarm system at the Gallup Indian Medical Center in Gallup, NM, with a project magnitude between $1,000,000 and $5,000,000. The contract will be a Firm Fixed Price (FFP) with a 180-calendar day performance period, evaluated using Lowest Price Technically Acceptable (LPTA) criteria. Eligible businesses must have an average annual revenue under $45 million over the past five years.
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Text version
16-161-SOL-00001
NCYRTC
Attachment J04 - Company Specialized Experience – Construction Form Solicitation Number: 75H701-26-R-00010
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 .