Attachment 1 Block 5_Rev.pdf

ATTACHMENT 1

CONSTRUCTION & DESIGN EXPERIENCE PROJECT DATA SHEET

Project No. (check one) : CON #1 CON #2 CON #3 CON #4 CON #5

DESIGN #1 DESIGN #2 DESIGN #3 DESIGN #4 DESIGN #5

1. Experience for: Offeror Joint-Venture Other (Explain)

Firm Name:

Address:

Phone Number:

Point of Contact: Contact Phone Number:

2. Work Performed as: Prime Contractor Sub Contractor Joint Venture Other (Explain)

Percent of project work performed:

If subcontractor, 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. Type of work:

Infrastructure Construction New Construction Renovation Repair Alteration Other (explain):

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

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

Complete Block 7 for Construction Projects. Complete Block 8 for Design Projects.

7. Construction Project:

Award Amount: Final Price:

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

Design-Build Design-Bid-Build Delivery/Task Order (IDIQ) Other (explain):

If Design-Build, identify the Lead Design Firm and design completion date:______________________________________

8. Design Project:

A/E Design Fee: Total Construction Value:

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

Design-Build RFP Development Designer of Record Engineering Services Full Plans & Specs

Other (explain):

9. Provide a detailed description of the project and the relevancy to the project requirements of this solicitation (i.e.: unique features, square footage, construction methods), including any sustainable features or USGBC LEED certifications. If design-build, include a description of the design-effort.

10. Provide a detailed description of what work your firm self-performed on this project:

11. Other Information: