RFP_Atch(5)_Offeror Experience Project Data Sheet_220525.docx

CUI//FEDCON [when filled in] Source Selection Information – See FAR 2.101 & 3.104 [when filled in] Inspection, Maintenance, Repair and Testing Services for VTE System & Equipment at MCAS Iwakuni, Japan N4008422R5401 Attachment (5)

Name of Offeror:

OFFEROR EXPERIENCE PROJECT DATA SHEET

Offeror must use this form to provide project information for Factor 1 – Corporate Experience. Individual blocks on this form may be expanded, however total length shall not exceed 1 double-sided (2 single-sided) pages; Pages submitted in excess of this, will not be considered/evaluated. The Offeror shall complete all sections in English.

Project No. (check one) : |_| #1 |_| #2 |_| #3 |_| #4 |_| #5

1. Contract Number: Delivery/Task Order Number:

Project Title:

Project Location:

2. Award Date (mm/dd/yy): Completion Date (mm/dd/yy):

Period of Performance (from mm/dd/yy to mm/dd/yy):

Project is % complete.

3. Award Amount: ¥ Final Price: ¥ Note: If contract amount is only in U.S. Dollars, convert using the exchange rate of FY22 BER at 106.4531 Yen/$.

4. Type of Contract (check all that apply): |_|Firm-Fixed-Price |_|Indefinite-Delivery, Indefinite-Quantity |_|Incentive |_|Cost Reimbursement |_|Time-and-Materials |_|Labor Hour |_|Basic Ordering Agreement |_|Blanket Purchase Agreement |_|Other (Explain):

5. Type of Work (check all that apply): |_|VTE Maintenance |_|VTE Inspection & Testing |_|VTE Repair/Restoration |_|Facility Support Services |_|Construction/Renovation |_|Other (Explain):

6. Customer/Owner Name:

Point of Contact Name/Title (person with project knowledge):

POC Phone Number: POC Email Address:

7. Name of Firm that Performed the Work:

The firm performed the work as (check one): |_|Prime Contractor |_|Subcontractor |_|Joint Venture |_|Other (Explain):

Percentage of work completed by Firm that performed the work:

If was project performed by JV, indicate percentage performed by each firm in JV:

If Subcontractor, identify Prime Contractor (Name/Phone #):

If the firm that performed the work for this project differs from the name of the Offeror submitting the proposal under this solicitation, identify the relationship to the Offeror below (check one):

|_| JV partner |_| Offeror was a Member of this JV |_| Affiliate |_| Subsidiary |_| Parent |_| LLC |_| LTD member company |_| Predecessor Company |_| Subcontractor

8. Provide a detailed description of the project and the relevancy to the project requirements of this RFP including specific types of work performed.

9. For this project, describe the role of the firm that performed the work (e.g., responsible for VTE maintenance, inspection, testing, repair, restoration, construction, project management, quality control, safety, cleanup, etc.). If work was performed by a JV, describe the work performed by each firm in the JV, including the work the Offeror self-performed on the JV project.

10. If the project was performed by an affiliate, subsidiary, parent, LLC, LTD member company, predecessor company, or subcontractor, describe the roles and responsibilities of the affiliate, subsidiary, parent, LLC, LTM member company, predecessor company, or subcontractor in terms of the work it will self-perform or manage on behalf of the Offeror in performance of the contract.

CUI//FEDCON [when filled in] Source Selection Information – See FAR 2.101 & 3.104 [when filled]