Experience_Form.docx

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Accreditation and Education Services
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Attachment 1

EXPERIENCE REPORTING FORM

Provide the following information to show up to three (3) examples of projects your company completed within the last 24 of 36 months indicating experience with projects of similar type and scope. Use one form per project.

Tracking Number: Project No.________of ____________.

a. Name of Firm:

b. Contract Number, Title and Location of Project:

c. Contract Type:

d. Describe how the contract referenced is relevant to the immediate acquisition. If only portions of the contract are relevant, specify which portions of the contract are relevant to the immediate acquisition:

e. Role (Prime, Joint Venture, or Subcontractor, etc.):

f. Contract or Subcontract (Award) Amount:

g. Describe any Work Subcontracted to Others (include names, addresses, and values):

h. Dates of Contract: Began: Completed:

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