W9127818R0058_Attachment_1_Prime_Contractor_Project_Data_Sheet.docx

Prime Contractor Project Data Sheet The Offeror shall provide the following information to show examples of the prime contractor’s company’s recent, relevant, specialized experience in similar type work. Use separate sheets for each project example.

1. Company Name: _____________________________________________________

2. Name of Project: _____________________________________________________

3. Location of Project: ___________________________________________________

4. Owner (i.e. customer work was completed for): _____________________________

5. Narrative Description of General Scope of Project/Contract as it relates to this solicitation:

6. Your Role (Prime, Subcontractor, Joint Venture, etc.) and type work Your Company Self- Performed other than management:

7. Cost for this single contract: ________________________

8. Extent and Type of Work Subcontracted Out:

9. Dates Project: Began Completed

10. Were You Terminated? ________If yes, attach an explanation.

11. Were you assessed Liquidated Damages? _______If yes, attach an explanation.

12. Provide comments regarding any known performance deemed unacceptable to the owner or not in accordance with the contract terms and conditions (use additional pages as necessary):

13. Name and contact information (telephone/email/etc.) of Owner’s point of contact:

End of ATTACHMENT 1