S02 - Attach 1 Experience Information Sheet.docx
DOCX document 23 KB Posted
- Solicitation number
- 36C24823R0091
About this file
This document contains an experience information sheet template and details of a federal contract opportunity for construction services. The opportunity is a set-aside for Service-Disabled Veteran-Owned Small Businesses issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 8. It seeks a contractor to resolve statement of conditions deficiencies at the C.W. Bill Young VA Medical Center in Bay Pines, Florida for a project magnitude between $500,000 to $1,000,000. Offerors must apply for and receive verification from the VA Center for Verification and Evaluation as an SDVOSB, be registered in VetBiz, and verified by the deadline in order to be considered for award. Joseph Wingfield of the VA is the point of contact for any questions at 307-712-5769 or atara.mcdonald@va.gov cc amber.milton@va.gov. The NAICS code is 236220 for construction projects and the small business size standard is $39.5M.
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Text version
EXPERIENCE INFORMATION SHEET
36C24822R0003 Attachment 6
EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 1 Must have a total of THREE (3) projects, more than 3 will not be evaluated; less than 3 may result in a lower rating.
a. Contractor Information of awarded contract (Firm Name, Address, DUNS Number and Cage Code, Phone number, POC Name, POC email, Company email)
b. Contract and/or Task Order Number and Award Date (mm/dd/yyyy)
c. Project Title/Name and Location
d. Work Performed as: Prime Contractor, Subcontractor, Joint Venture, Other (explain)
e. Percent (%) of project work performed by your company
f. if you work as subcontractor, who was the prime?
(Firm Name, Address, DUNS Number and Cage Code, Phone number, POC Name, POC email, Company email)
g. Government Agency/Company which awarded contract to offeror, and Contact Information, such Contracting Officer/Procurement Official/Point of Contract (Name, Title, Email, Phone Number).
EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 2
h. Description of project’s scope of work and the offeror’s specific roles and responsibilities in the project: Describe work performed in sufficient detail to permit evaluation of project relevancy to this procurement. Detail how work performed is relevant to the effort required by the solicitation? Use continuation sheet for additional information, if necessary
EXPERIENCE INFORMATION SHEET
PROJECT NO. [ ] Page 3
i. Describe any difficulties and/or obstacles encountered during performance; steps taken toward resolution
j. Describe unforeseen conditions and how each were resolved
k. Performance Period, including contract start date (mm/dd/yyyy), and original completion date, if not completed, projected date (mm/dd/yyyy) contract start date:
original completion date, if not completed, projected completion date (mm/dd/yyyy)
l. Actual Completion Date (mm/dd/yyyy), and if not completed, why?
Actual Completion Date:
If not completed, Why?
m. Project is 50% or more complete? YES [ ] No [ ]. If “No” explain percentage of completion, if not 50% completed for any reason, rating may be lower.
n. The Offerors shall indicate if any of the contracts listed were terminated and the type and reasons for the termination.
o. Original Contract Price (Award Amount), Final Contract Price (to include all modifications, if applicable), Explain Differences.
Original Contract Price: Final Contract Price:
Explain Differences:
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