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Attachment_J-0200000-13.pdf

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FACTOR 1 - RELEVANT EXPERIENCE INDIVIDUAL PROJECT DATA SHEET

Provide one (1) project data sheet for each

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):

If the project is not complete, is it at least 80% complete: Yes No

5. Award Amount: (Overall contract/task order value) Final Price:

6. Type of work:

New Construction Renovation Repair Alteration Other Explain)

7. Type of Contract: (Check all that apply)

Single Project Contract Delivery/Task Order (IDIQ) On-Call Contract Other (explain):

8. Type of Contract: (Check all that apply)

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

9. Customer/Owner Information:

Customer Name:

Point of Contact (POC): POC Phone Number:

FAX Number: E-mail address:

10. Evaluation Received:

Excellent Highly Acceptable Satisfactory Marginal Poor (or equivalent scoring) Special Acknowledgements:

11. Project Information:

12. Unique Project Challenges or Accomplishment:

13. Previous Relationship

If experience is a subcontractor or a joint-venture indicate if:

Previous joint-venture experience No previous joint-venture experience Previous prime-subcontractor experience No previous prime-subcontractor experience Other relationship experience Explain:

15 . Other Information:

ATTACHMENT J-0200000-13 – Relevant Experience Project Checklist

Corporate Experience

Personnel Experience

Project Name

Contract Number Scope

Offeror/key Personnel Role Project Amount Completion Date

Key Manager

Customer

POC

Awarded Completed Delta Scheduled Actual Delta

SAMPLE INVOICE FORM
FORMS
J-0200000-05-04
ACCIDENT FORM continued
LEAD MATERIALS
THERMOSTATS AND SWITCHES
BATTERIES
PCB CONTAINING MATERIALS
PCB LEAKS
OZONE DEPLETING SUBSTANCE (ODS)
FIRE SUPPRESSION CONTAINERS
PETROLEUM, OILS, AND LUBRICANTS (POL'S)
WETLANDS
CULTURAL RESOURCES
AIR COMPLIANCE
2 2 FEB 2016
ASO 11010.5D
2 2 FEB 2016
ATTACHMENT J-0200000-12
CONTRACTOR’S SELF-PERFORMANCE CERTIFICATION
AND NOTIFICATION OF SUBCONTRACTING
Section J -J-0200000.pdf
SAMPLE INVOICE FORM
FORMS
J-0200000-05-04
ACCIDENT FORM continued
LEAD MATERIALS
THERMOSTATS AND SWITCHES
BATTERIES
PCB CONTAINING MATERIALS
PCB LEAKS
OZONE DEPLETING SUBSTANCE (ODS)
FIRE SUPPRESSION CONTAINERS
PETROLEUM, OILS, AND LUBRICANTS (POL'S)
WETLANDS
CULTURAL RESOURCES
AIR COMPLIANCE
2 2 FEB 2016
ASO 11010.5D
2 2 FEB 2016
ATTACHMENT J-0200000-12
CONTRACTOR’S SELF-PERFORMANCE CERTIFICATION
AND NOTIFICATION OF SUBCONTRACTING

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