OA 2 - Specialized Experience Form (Construction).docx
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- Solicitation number
- 75H70126R00002
About this file
The document is a Specialized Experience Form for a Design-Build Construction Project for the Alamo Navajo Health Center. The form is part of a Phase I Request for Qualifications (RFQ) solicitation by the Indian Health Service (IHS) for a new 70,000-square-foot comprehensive outpatient wellness facility. The project is located on the Alamo Navajo Indian Reservation in New Mexico, with an estimated contract value between $80-$120 million. The form requires contractors to demonstrate their specialized construction experience by detailing previous projects completed within the last six years, including project type, construction cost, role, scope, and owner references. The solicitation is unrestricted and open to both large and small businesses under NAICS code 236220, with a size standard of $45.0 million, and aims to replace the existing IHS clinic to serve approximately 2,650 tribal residents.
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Text version
16-161-SOL-00001
NCYRTC
75H70126R00002 Alamo Navajo Health Center Design-Build Optional Attachment 2 Company Specialized Experience (Construction or Prime Contractor) Section 1 – Factor 1 – Specialized Experience Response to Phase I Solicitation
While this exact form is not required, the same information must be provided. Provide the following information to show examples of projects your company constructed within the last six (6) years and that are at least 75% construction complete as of the date of Phase I proposal submission indicating experience with projects of similar type and scope. Use one form per project.
Type of Project Represented Your Firm’s Name Name of Project Location of Project Owner General Scope of Construction Project Your Role (Prime, Joint Venture, or Subcontractor, etc.) and Work Your Company Self-Performed :
Construction Cost Extent and Type of Work You Subcontracted Out Dates Construction: Began___________________ Completed______________ % Completed _______ Your Performance Evaluation by Owner, if known Were You Terminated or Assessed Liquidated Damages?
(If either is “Yes”, attach an Explanation) Owner’s Point of Contact for Reference (Name and Company) Current Telephone Number of Reference POC
SOURCE SELECTION SENSITIVE For Official Use Only
FOR OFFICIAL USE ONLY, SOURCE SELECTION INFORMATION (FAR 3.104)
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