N4008026SENER_Project Information Form.docx

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SOURCES SOUGHT SPECIAL NOTICE FOR DB/DBB MULTIPLE AWARD CONSTRUCTION CONTRACT (MACC) ENERGETICS PROJECTS
Solicitation number
N4008026SENER
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This is a Project Information Form template designed for contractors responding to a Sources Sought Notice (SSN) for Naval Facilities Engineering Systems Command (NAVFAC) Washington regarding Design-Build/Design-Bid-Build multiple award construction contracts (MACC) for energetics projects. The form requests submission of up to three relevant projects per contractor to demonstrate experience and capability in this specialized contracting area.

The form collects standard project data including contractor name and UEI, contract number, award and completion dates, final contract price, project scope (new construction, repair, or renovation), customer information, and contract type. A critical focus area addresses specialized experience requirements specific to explosives safety and energetics work, requiring contractors to document experience with: Department of War explosives safety site approval submittal and approval processes reviewed by EXWC/CEHNC with NOSSA and DWESO approval; designing and analyzing structures to resist accidental explosions per UFC 3-340-02 and DESR 6055.09; applying DoW and Navy explosives safety criteria including NAVSEA OP-5; hazard analysis and risk mitigation; quantity distance analysis and explosives safety siting; UFC compliance across all disciplines; and work in UXO areas requiring Explosives Safety Submissions (ESS) or ESS-Determination Requests. Contractors must specify whether they served as prime contractor, percentage of work self-performed, contract type, and provide detailed explanations of demonstrated experience in each applicable specialty area. Responses are limited to two pages per project and are voluntary, non-binding submissions intended solely for market research and procurement planning purposes.

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SOURCES SOUGHT ATTACHMENT – PROJECT INFORMATION FORM

N4008026SENER

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to three projects. Please limit response to two pages per project.

1.

Contractor Name: Click or tap here to enter text.

Contractor UEI: Click or tap here to enter text.

2.
Project No. (check one):
☐ 1☐ 2☐ 3

3. Contract Number: Click or tap here to enter text.

Task Order/Delivery Order Number: Click or tap here to enter text.

Project Title: Click or tap here to enter text.

4.
Award Date (mm/dd/yy): Click or tap here to enter text.
5.
Final Contract Price:

$Click or tap here to enter text.

Completion Date (mm/dd/yy):
Click or tap here to enter text.(includes all options and mods)

Project is Click or tap here to enter text. % complete (as of this SSN due date)

6.
Type of work:
☐ New Construction☐ Repair☐ Renovation
7.
Customer/Owner Name:
Click or tap here to enter text.
Point of Contact Name/Title: (person with project knowledge)
Click or tap here to enter text.
POC Email/Phone:
Click or tap here to enter text.Click or tap here to enter text.
8.
Were you the Prime contractor for this project?
☐ Yes☐No
9.
Type of Contract (check all that apply):

☐ Design-Build ☐ Design-Bid-Build (fully designed project)

☐ Other (explain):
Click or tap here to enter text.
If Design-Build, provide the following information:
☐Design accomplished in-house
Lead design firm name:
Click or tap here to enter text.Years working together: Click or tap here to enter text.
Address:
Click or tap here to enter text.
10. Provide a general description of the project:

Click or tap here to enter text.

11. Percentage of work you self-performed on this project: Click or tap here to enter text.%.

Provide a detailed description of the work your firm self-performed on this project:

Click or tap here to enter text.

12. Please provide additional detail in the demonstrated experience (Check all experience that applies to this particular project)

☐ Experience managing the DoW explosives safety site approval submittal and approval process with demonstration of projects reviewed by EXWC/CEHNC and that have received final Naval Ordnance Safety and Security Activity (NOSSA) approval by the Department of War Explosives Safety Office (DWESO, formerly

DDESB)

Explain:
Click or tap here to enter text.

☐ Experience designing and analyzing structures and protective construction to resist accidental explosions (internal and external) in strict accordance with UFC 3-340-02 and DESR 6055.09

Explain:
Click or tap here to enter text.

☐ Experience applying and complying with DoW and Navy explosives safety criteria, including NAVSEA OP-5 (Ammunition and Explosive Ashore Safety Regulations)

Explain:
Click or tap here to enter text.

☐ Experience with development of Hazard analysis and incorporation of risk mitigations into designs.

Explain:
Click or tap here to enter text.

☐ Experience utilizing Quantity Distance analysis and explosives safety siting.

Explain:
Click or tap here to enter text.

☐ Experience applying and complying with UFC’s, for all disciplines and facility types under this MACC.

Explain:
Click or tap here to enter text.

☐ Experience working in UXO areas that require an Explosives Safety Submission (ESS) or Explosives Safety Submission-Determination Request (ESS-DR) and providing input for those submissions.

Explain:
Click or tap here to enter text.

Form may be expanded. Please DO NOT change content of the form

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