A05_Similar_Project_Template.pdf

SIMILAR PROJECT TEMPLATE, SECTION L - INSTRUCTIONS RFP NIHOF2015030

Project Title:

Offeror:

Project Owner:

Offeror’s Role on Contract: (Prime, Subcontractor, JV Partner) Contract Number:

Project Location: Award Date:

Type of Service: ( Enter one - Design/Build, Alteration, Renovation, Repair, New Construction)

Facility Type: Check all that apply Interior & Occupied [ ] Exterior [ ] Hospital [ ] Laboratory [ ] Pharmaceutical [ ] Manufacturing [ ] Utility Space [ ] Other [ ] (Please state)

Work over or within close proximity with Energized 13,800 volt Equipment?

Yes_____ No_____ (Provide details in narrative below) Original Project Cost: Ending Project Cost:

Original Project Completion Date: Ending Project Completion Date:

Orignal Period of Performance: If On-going, Percent Complete:

Number of Lost Days Due to Accidents/Injuries: % of Electrical Work Self-Performed:

# Change Orders Submitted to Owner: # Change Orders Awarded by Owner:

# Owner Change Orders: Total # Change Orders:

Project’s Targeted SB Subcontracting Participation (%):

Project’s Achieved SB Subcontracting Participation (%):

Customer Contact: (Must be the same individual completing Factor A – Past Performance Questionaire)

Customer Email:

Project Description: (Provide a description of the work and address the key components and characteristics of the project that are relevant to the NIH requirement as defined in Section L – Instructions). Include explanation for any cost or schedule increases.