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This document is a Sources Sought Project Data Form template to be used by contractors to provide up to five examples of relevant project experience for an indefinite delivery indefinite quantity asphalt and concrete repair and replacement contract in the Hampton Roads, Virginia area of responsibility. Contractors should provide details on past projects including contract numbers, award and completion dates, final contract values, types of work performed, customer and point of contact information, whether the contractor served as prime or subcontractor, contract types utilized, self-performed work percentages and descriptions. The related federal contract opportunity is being solicited by the Naval Facilities Engineering Command of the Department of the Navy for asphalt and concrete repair and replacement services in the Hampton Roads region of Virginia.

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SOURCES SOUGHT – CONSTRUCTION EXPERIENCE PROJECT DATA FORM

Use this form (one per project) to provide supporting information that demonstrates project experience relevant to the subject announcement. Submit up to five (5) projects. Please limit response to two pages per project.

1.
Contractor Name:
2.
Project No. (check one):
|_| - 1|_| - 2|_| - 3|_| - 4|_| - 5
3.
Contract Number:
Delivery/Task Order No.:
Project Number:
Title:
Location:
4.
Award Date (mm/dd/yy):
5.
Final Contract Price:
$
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.
Type of work:
|_| New Construction|_| Repair|_| Renovation
7.
Customer/Owner Name:
Point of Contact Name/Title: (person with project knowledge)
POC Phone Number:
POC Email Address:
8.
Were you the Prime contractor for this project?
|_| Yes|_| No
Were you a subcontractor for this project?
|_| Yes|_| No
If subcontractor, who was the Prime contractor?
9.
Type of Contract (check all that apply):

|_| Design-Build |_| Design-Bid-Build (fully designed project)

|_| Other (explain):
If Design-Build, provide the following information:
|_| Design accomplished in-house
Lead design firm name:
Years working together:
Address:

10. Provide a detailed description of the project:

11. Percentage of work you self-performed on this project: %.

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

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

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