RFP ONLY - Attachment 04 - Corporate Experience Questionaire.docx

RFP Only - Attachment 04 Corporate Experience Questionnaire Medical Staffing Services

Please complete the Corporate Experience Questionnaire by providing the demographic and corporate experience information for your firm below. Offerors may provide up to three (3) reference projects for ongoing projects or projects completed within the last five (5) years of the date of this RFQ demonstrating relevant experience performing projects similar in size, scope, and complexity to this requirement. A project is considered a single contract or task/delivery order, or a collection of orders under a BPA or IDIQ contract. The Offeror’s response must provide a clear, specific, and concise description of its relevant corporate experience. Any state, local, or private sector experience can be considered. Extraneous narrative, elaborate brochures, public relations (PR) material, etc. shall not be submitted. If Offerors choose to submit as a prime/sub team or under a contractor teaming arrangement (CTA), please indicate which firm’s experience is being demonstrated. Offerors may choose only to submit as a prime.

The Corporate Experience Questionnaire must be submitted to the OAQDCRSW@ICE.DHS.GOV prior to the date and time for the Offeror’s scheduled Oral Presentation in accordance with Section L.6 of the RFP.

The Government reserves the right to use any information provided in this document to assist in the evaluation of Factor 5 – Past Performance.

1. Firm Information

Firm’s Name and Address:

Name and Title of Representative:

Phone:

Fax:

E-mail Address:

Labor Categories provided under projects:

If teaming with another firm(s), list their name(s) and address(es):

Firm 1 - Name:

Address:

Firm 2 - Name:

Address:

(NOTE: If more than two partners are proposed, add the remaining information on a separate sheet of paper.)

Has this team worked together previously: □ Yes □ No GSA Contract #:

FSS Schedule #:

Contract Period:________________________________________________________

2. List up to three [3] projects which demonstrate the firm's or team's prior experience performing work similar to that required by the PWS using the format below:

Project Name and Location

Nature of the work performed

Customer Name and Address

The Firm’s Project Manager's Name and Phone Number

Period of Performance and Percentage Complete

Estimated or Final Value

Project Name and Location

Nature of the work performed

Customer Name and Address

The Firm’s Project Manager's Name and Phone Number

Period of Performance and Percentage Complete

Estimated or Final Value

Project Name and Location

Nature of the work performed

Customer Name and Address

The Firm’s Project Manager's Name and Phone Number

Period of Performance and Percentage Complete

Estimated or Final Value

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