J05 - Company Specialized Experience Form Construction.docx
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- Solicitation number
- 75H701-23-R-00048
About this file
This solicitation notice is for a construction project to replace the sprinkler system, HVAC units, and communication cabling at the Peach Springs Health Center in Peach Springs, Arizona. The Indian Health Service intends to award a single firm fixed price contract for a contractor to furnish all labor, materials, equipment, and supervision to complete the project, which must be finished within 365 calendar days of the notice to proceed. The magnitude of the construction work is estimated to be between $1 million and $5 million. Interested offerors should register in the System for Award Management and carefully review amendments to the full solicitation, as it will not be available in hard copy. The solicitation will use low price technically acceptable source selection procedures to evaluate proposals received in response to request for proposal number 75H701-23-R-00048 by the scheduled closing date.
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Text version
16-161-SOL-00001
NCYRTC
Attachment J05 - Company Specialized Experience – Construction Form Solicitation Number: 75H701-23-R-00048
COMPANY SPECIALIZED EXPERIENCE – CONSTRUCTION FORM
Provide the following information to show examples of projects your company constructed within the last seven (7) 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 75H701-23-R-00048
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