RELEVANT_EXPERIENCE_FORM.pdf

267 KB Posted

Attached to
PEACH Collaborative
Solicitation number
2022-RFP-131
Issued by
Los Angeles County, California

About this file

Written by GovTribe AI ·

The document is a Relevant Experience Form, designed for a bidder to provide details about their previous project experiences, likely in connection with the PEACH Collaborative initiative by the Pasadena Public Health Department (PPHD). The form is structured to capture information for up to five different projects, with each project section requiring details such as project name, address/location, start and completion dates, contract description, and contract owner information. The form appears to be part of a bid submission process, allowing potential contractors to demonstrate their past performance and expertise in projects similar to the PEACH Collaborative's scope.

The form itself does not contain any specific pricing information, set-asides, or funding details. It is a template for contractors to showcase their relevant experience, which will likely be evaluated as part of the overall bid assessment for the PEACH Collaborative. The collaborative, funded by the CDC Disparities Program, aims to partner with community-based organizations to implement solutions and provide wellness resources for communities disproportionately impacted by COVID-19, with a specific focus on increasing vaccine confidence among Hispanic/Latinx and Black/African American communities, as well as parents of children and infants ages 0-11.

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RELEVANT EXPERIENCE FORM

Please complete the next five (5) pages to demonstrate experience with projects of similar scope and size to that which is to be performed. This completed form will be submitted with bid.

Project No. 1

Project Name ____________________________________________

Project Address/Location ___________________________________________________________

Date of Start/Completion of Project ___________________________

Contract Description

Contract Owner Information:

Owner __________________________________________________________

Name of Contact __________________________________________________

Title ____________________________________________________________

Address _________________________________________________________

Phone Number __________________________ Email ____________________

Project No. 2

Project Name ____________________________________________

Project Address/ Location_________________________________________________________

Date of Start/Completion of Project ___________________________

Contract Description

Contract Owner Information:

Owner __________________________________________________________

Name of Contact __________________________________________________

Title ____________________________________________________________

Project No. 3

Project Name ____________________________________________

Project Address/ Location___________________________________________________________

Date of Start/Completion of Project ___________________________

Contract Description

Contract Owner Information:

Owner __________________________________________________________

Name of Contact __________________________________________________

Title ____________________________________________________________

Project No. 4

Project Name _____________________________________________________________

Project Address/ Location________________________________________________________

Date of Start/Completion of Project ___________________________

Contract Description

Contract Owner Information:

Owner __________________________________________________________ Name of Contact __________________________________________________ Title ____________________________________________________________

Project No. 5

Project Name ____________________________________________________________________

Project Address/ Locaton___________________________________________________________

Date of Start/Completion of Project ___________________________

Contract Description

Contract Owner Information:

Owner __________________________________________________________ Name of Contact __________________________________________________ Title ____________________________________________________________

ADDENDUM NO. 3
Work Experience.pdf
2021-08-13 100%CD Allendale Branch Library Seismic Retrofit Phase 1.pdf
Sheets
S0.0 - SHEET INDEX, ABBREVIATIONS AND SYMBOLS
S0.1 - GENERAL NOTES
S1.0 - ROOF FRAMING PLAN
S2.0 - EXTERIOR ELEVATION
S3.0 - MISC DETAILS
S3.1 - MISC DETAILS
S4.0 - TYPICAL WOOD DETAILS
Project Name:
Project AddressLocation:
Date of StartCompletion of Project:
Contract Description 1:
Contract Description 2:
Contract Description 3:
Contract Description 4:
Contract Description 5:
Contract Description 6:
Contract Description 7:
Contract Description 8:
Owner:
Name of Contact:
Title:
Address:
Phone Number:
Email:
Project Name_2:
Project Address Location:
Date of StartCompletion of Project_2:
Contract Description 1_2:
Contract Description 2_2:
Contract Description 3_2:
Contract Description 4_2:
Contract Description 5_2:
Contract Description 6_2:
Contract Description 7_2:
Contract Description 8_2:
Owner_2:
Name of Contact_2:
Title_2:
Address_2:
Phone Number_2:
Email_2:
Project Name_3:
Project Address Location_2:
Date of StartCompletion of Project_3:
Contract Description 1_3:
Contract Description 2_3:
Contract Description 3_3:
Contract Description 4_3:
Contract Description 5_3:
Contract Description 6_3:
Contract Description 7_3:
Contract Description 8_3:
Owner_3:
Name of Contact_3:
Title_3:
Address_3:
Phone Number_3:
Email_3:
Project Name_4:
Project Address Location_3:
Date of StartCompletion of Project_4:
Contract Description 1_4:
Contract Description 2_4:
Contract Description 3_4:
Contract Description 4_4:
Contract Description 5_4:
Contract Description 6_4:
Contract Description 7_4:
Contract Description 8_4:
Owner_4:
Name of Contact_4:
Title_4:
Address_4:
Phone Number_4:
Email_4:
Project Name_5:
Project Address Locaton:
Date of StartCompletion of Project_5:
Contract Description 1_5:
Contract Description 2_5:
Contract Description 3_5:
Contract Description 4_5:
Contract Description 5_5:
Contract Description 6_5:
Contract Description 7_5:
Contract Description 8_5:
Owner_5:
Name of Contact_5:
Title_5:
Address_5:
Phone Number_5:
Email_5:

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