Attachment_V_Exp_Proj-Data-Sheet.doc

ATTACHMENT V

PROJECT DATA SHEET

Project No. (check one) : FORMCHECKBOX

EXP #1 FORMCHECKBOX

EXP #2 FORMCHECKBOX

EXP #3 FORMCHECKBOX

EXP #4 FORMCHECKBOX

EXP #5

1. Experience for: FORMCHECKBOX Offeror FORMCHECKBOX Joint-Venture FORMCHECKBOX Other (Explain) Firm Name:

Address:

Phone Number:

Point of Contact: Contact Phone Number:

2. Work Performed as: FORMCHECKBOX Prime Contractor FORMCHECKBOX Sub Contractor FORMCHECKBOX Joint Venture FORMCHECKBOX 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):

5. Type of work:

FORMCHECKBOX

New Construction FORMCHECKBOX Renovation FORMCHECKBOX Repair FORMCHECKBOX Alteration FORMCHECKBOX Other (explain):

6. Type of Contract/Task Order: (Check ALL that apply)

FORMCHECKBOX

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

7. Project:

Award Amount: Final Price:

8. Customer/Owner Name:

Point of Contact (POC): POC Phone Number:

FAX Number: POC E-mail address:

9. Provide a detailed description of the project and the relevancy to the project requirements of this RFQ (i.e.: unique features, square footage, methods, occupied facilities), including any sustainable features or USGBC LEED certifications.

10. Provide a detailed description of what work your firm self-performed on this project:

11. Other Information:

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Attachment A