J-0200000-13_CORPORATE_EXPERIENCE_FORM.pdf

ATTACHMENT J-0200000-13

CORPORATE EXPERIENCE FORM

FACTOR 1 - CORPORATE 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:

RAO Project LTM Projects Other Environmental Services 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: