Encl 2_Contractor Information Form.docx
DOCX document 28 KB Posted
- Solicitation number
- N4008424R0091
About this file
This is a Contractor Information Form template associated with Sources Sought Notice N40084-25-R-0091 for the United States Naval Hospital (USNH) Yokosuka Alteration project in Japan. The form consists of two main sections: a general information section requesting contractor details (firm name, Unique Entity ID, CAGE code, contact information) and project experience section where contractors can submit up to five relevant projects.
The form requires contractors to indicate their experience with similar construction projects, outline primary concerns regarding equipment, materials, utilities, contract duration, delivery schedules, transportation, and shipping. For each project submission, contractors must provide contract numbers, award dates, final contract prices (in USD or Yen), completion dates, customer information, contract types (Design-Build, Design-Bid-Build, etc.), work types (new construction, renovation, alteration, repair, demolition, design), and percentage of self-performed work. The form is limited to 2 pages per project submission and must not be modified beyond expanding the existing fields.
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Other files
| File | Type | Posted |
|---|---|---|
| Encl 1_Description of Proposed Construction.pdf |
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Text version
SOURCES SOUGHT NOTICE N40084-25-R-0091
UNITED STATES NAVAL HOSPITAL (USNH) YOKOSUKA ALTERATION
COMMANDER FLEET ACTIVITIES YOKOSUKA (CFAY), YOKOSUKA, JAPAN
Use this form to provide contractor’s general information and any concerns for this project.
1. Contractor Information:
| Firm Name: |
| Unique Entity ID Number: |
| CAGE Code: |
Address:
| Point of contact for firm: |
| Phone Number of POC: |
| Email of POC: |
2. Does your company regularly engage in the business of providing construction type projects similar to the scope of work in the sources sought? |_| YES |_| NO If yes, list specific types of tasks/services provided and how long your company has provided these types of services:
Number of years these types of services have been provided:
3. What are your primary concerns for this project? What constraints are important to clarify in the construction contract, with respect to equipment, materials, utilities, contract duration, delivery schedules, transportation, shipping, etc?
4. This space may be used to provide any additional information that is relevant.
SOURCES SOUGHT NOTICE N40084-25-R-0091
UNITED STATES NAVAL HOSPITAL (USNH) YOKOSUKA ALTERATION
COMMANDER FLEET ACTIVITIES YOKOSUKA (CFAY), YOKOSUKA, JAPAN
Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement (similar in size, scope, complexity). Submit up to 5 projects. Limit response to 2 pages per project.
| 1. |
| Contractor Name: |
| 2. | |||
| Project No. (check one): | |||
| |_| - 1 | |_| - 2 | |_| - 3 | |_| - 4 |_| - 5 |
| 3. Contract Number: |
| Delivery/Task Order No.: |
| Title: |
| Location: |
| 4. |
| Award Date (mm/dd/yy): |
| 5. Final Contract Price: |
| $ or ¥ |
| Completion Date (mm/dd/yy): |
| (includes. all options and mods) |
| Project is % complete (as of submission due date) |
| This is the |_| total project |_| subcontract price. |
| 6. Customer/Owner Name: |
Point of Contact Name/Title:
(person with project knowledge)
| POC Phone Number: |
| POC Email Address: |
| 7. |
| Were you the Prime contractor for this project? |
Were you a subcontractor for this project?
If subcontractor, who was the Prime contractor?
| |_| Yes | |_| No | |
| |_| Yes | |_| No |
8. Type of Contract (check all that apply):|_|Design-Build |_|Design-Bid-Build |_|Firm-Fixed Price |_|Cost/Time & Material |_| Other (explain):
If Design-Build, provide the following information: |_| Design accomplished in-house
Lead design firm name:
Address:
Years working together:
9. Type of work: |_| New Construction |_| Renovation |_| Alteration |_| Repair |_| Demolition |_| Design
10. Narrative Description of the Project:
11. Percentage of work you self-performed on this project: % and (dollar value).
Explain work self-performed:
(Rev. 03/13) **Form may be expanded. Please DO NOT change content of the form.** (Rev. 03/13)
File details come from the government source that posted it. Updated .