S02-Attachment 06-Project Experience Questionnaire-W Haven.docx
DOCX document 105 KB Posted
- Solicitation number
- 36C77625R0060
About this file
This document is a Project Experience Questionnaire for a VA healthcare facility renovation project at the West Haven Campus in Connecticut. The questionnaire is designed to capture detailed information about a contractor's previous project experience, specifically focusing on elements relevant to the current solicitation for an Interventional Radiology Suite Renovation Design-Build (D-B) project.
The questionnaire requires contractors to provide comprehensive details about past projects, including project title, location, description, owner information, and contractor roles. Key evaluation areas include greenfield civil work, multi-discipline coordination, experience with medical gases, working in medical facilities, and managing construction challenges around large medical imaging equipment. Contractors must detail project changes in pricing and scheduling, and highlight additional project information that demonstrates their capability to execute the VA Connecticut Healthcare System project at 950 Campbell Avenue, West Haven, CT. The solicitation (36C77625R0060) is being managed by the Department of Veterans Affairs Technology Acquisition Center in Austin.
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Text version
VA PROGRAM CONTRACTING ACTIVITY CENTRAL ● 6100 OAK TREE BLVD SUITE 490 ● INDEPENDENCE, OH 44131
Project Experience Questionnaire
Submit responses to the questions below that address experience relative to the elements within the current solicitation. Limit submittals to the quantity of projects and timeframes required in the solicitation. Expand the response sections shown below as needed to adequately address each question (this questionnaire may be expanded to multiple pages if needed). Including any photos, narratives, and charts that may help demonstrate project experience and relevancy.
| Offeror |
| Company Name |
REFERENCED PROJECT INFORMATION
| Project Title |
| Title |
| Project Location |
| City, State |
| Brief Project Description |
| Description |
| Project Owner |
| Company Name |
| POC: |
| First & Last Name |
| Phone: |
| (XXX) XXX-XXXX |
CONTRACTOR LIST
List Contractor(s) whose experience on the referenced project is being submitted for evaluation on this proposed project. If more than one contractor is listed (i.e. prime and subcontractors), provide information specific to that contractor.
| Contractor Name |
| Role on Referenced Project |
(Prime or Sub)
| Trade |
| Price |
(list for each contractor’s specific work) Performance Period (calendar days) (list for each contractor’s specific work)
| Original |
| Final |
| Original |
| Final |
| Name |
| Prime |
| Prime |
| $XXX |
| $X,XXX |
| XX |
| XX |
| Name |
| Subcontractor |
| Plumbing |
| $X,XXX, |
| $X,XXX |
| XXX |
| XXX |
| Name |
| Subcontractor |
| Mechanical |
PROJECT EXPERIENCE QUESTIONS
1. Describe the project work.
Response
2. Identify which Project Experience elements relate to the current solicitation. Specifically address: greenfield civil work, multi-discipline coordination, working with medical gases, working at medical facility, and consideration of construction challenges around large medical imaging equipment, if applicable.
Response
3. Describe & provide reasons for any changes to the original price for the project.
Response
4. Describe and provide reasons for any changes to the original schedule for the project.
Response
5. Provide any other additional project information you believe should be presented.
Response image1.tiff
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