Attachment 24- CH50091-2P Attachment 4 Experience Information.doc

Attachment 24- CH50091-2P Attachment 4 Contractor:

Contract Number:

EXPERIENCE INFORMATION SHEET

(Document will expand as narrative is inserted. Limit size to two pages.)

1. Project No. (from Experience Overview Sheet):

2. Project Name & Client:

3. Location work was performed:

4. Date work was completed (must be within last 6 years):

a. If work is still ongoing, date work was 50% completed:

b. If not 50% completed, explain percentage of completion:

5. Final cost of this project:

6. Clearly describe what part of the work was performed by the firm for which the experience information is submitted. Provide dollar magnitude for each of the following categories if multiple categories are selected.

a. Building renovations, including floors, doors, walls, windows, and external facades:

b. Repair/replacement of major building systems such as electrical, mechanical, and HVAC:

c. Civil work, including earthwork and drainage structures:

d. Environmental work:

7. Work was performed as a: FORMCHECKBOX Prime FORMCHECKBOX Joint Venture FORMCHECKBOX Subcontractor RTOP Number: [Insert RTOP Number]

Project Title: Renovate & Expand Bldg-29608