ATTACHMENT_NO._3_ORGANIZATIONAL_EXPERIENCE_FORM__DEMONSTRATING_CAPABILITY.doc

ORGANIZATIONAL EXPERIENCE FORM DEMONSTRATING CAPABILITY

Format For Submission of Recent/Relevant Experience Within the Last 3 Yeas

(To be completed by Contractor)

1. Contractor/Subcontractor:

Name:

Address:

2. Contract /TO/PO Number:

3. Solicitation Type:

FORMCHECKBOX

RFQ FORMCHECKBOX

RFP FORMCHECKBOX

IFB

4. Contract/TO/PO Type: FORMCHECKBOX Fixed-Price

FORMCHECKBOX

Cost Reimbursement FORMCHECKBOX Hybrid (explain)____________

Routine → Difficult

5. Complexity of Work 1 2 3 4 5

6. Contract/TO/PO Dollar Value:

7. Contract/TO /PO Status:

FORMCHECKBOX

Active FORMCHECKBOX Complete

Completion Date (w/ extensions):

8. Project Description, to include location & relevancy of work to the Statement of Work of this RFP:

9. Problems encountered and how resolved:

10. Name, Address, Telephone Number of Customer: