Project Information Sheet.pdf

PROJECT INFORMATION SHEET

Name of Offeror:

Provide information for relevant RADON MITIGATION projects to be used for PAST PERFORMANCE evaluation purposes. For each project, provide the following information (use additional sheets as necessary, but no more than 2 pages per project):

a. Type of project (check one):

Radon Mitigation ______ Other ______

b. Contract or Task Order Number/Project Title:

c. Location/Site (i.e. Misawa AB, Japan):

d. Name of Company/Firm Involved in this project (if other than the Offeror or if Offeror is a Joint Venture):

e. Nature of Involvement in this project (i.e. Prime Contractor):

f. Contract Value:

Modifications (number of and total cost of all mods):

Final Contract Price: _______________

Reason for Modification(s):

g. General Scope of Project:

h. Identify key work disciplines your company/firm employed on this project:

Provide two Points of Contact for Client/Agency (if client is the U.S. Government, provide name and address of contracting office, contract number, name and telephone number of Contracting Officer):

(1)

Name: ______________________________________________________________

Telephone No.________________________ Fax No._________________________

E-mail: _____________________________________________________________

Address: ____________________________________________________________

(2)

Name: ______________________________________________________________

Telephone No.________________________ Fax No._________________________

E-mail: _____________________________________________________________

Address: ____________________________________________________________

j. Extent and Type of Work Subcontracted (if applicable):