Attachment A - Offeror Experience Form.pdf

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Attached to
COUGAR SPILLWAY GATE TWO REHABILITATION
Solicitation number
W9127N-22-R-0027
Issued by

About this file

This document contains an Offeror Experience Form to be submitted in response to Solicitation Number W9127N-22-R-0027 from the Department of the Army Corps of Engineers Engineering District Portland. The solicitation seeks rehabilitation of Cougar Dam Spillway Gate Two to current design standards to improve reliability. Specifically, the project will fully rehabilitate one gate, repair/replace hoist equipment, install staff gauges, replace electrical and distribution equipment, re-conduct wiring, install secondary containment for oil and grease sources over 50 gallons, and replace or install handrails and fall protection equipment. Offerors must provide the Offeror Experience Form with details of relevant past projects as a prime contractor, subcontractor, or joint venture, including percentage of work performed, roles and responsibilities, and tasks accomplished similar to the solicitation requirements.

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FOR OFFICIAL USE ONLY

SOURCE SELECTION SENSITIVE INFORMATION

Source Selection Information -- See FAR 2.101 and 3.104.

ATTACHMENT A

OFFEROR’S EXPERIENCE FORM

NAME OF OFFEROR: ____________________________________________________________________

PROJECT TITLE: ________________________________________________________________________

CONTRACT NUMBER: ___________________________________________________________________

GEOGRAPHIC LOCATION: _______________________________________________________________

CONTRACT AWARD AMOUNT (U.S. DOLLAR) $______________________________________________

FINAL CONTRACT AMOUNT (U.S. DOLLAR) $________________________________________________

CONTRACT COMPLETION DATE: __________________________________________________________

CONTRACT DURATION (PERIOD OF PERFORMANCE): ________________________________________

(If not complete, provide % currently complete)

DESCRIPTION OF THE PROJECT’S SCOPE AND MAGNITUDE: (The description should provide sufficient detail to demonstrate the similarities with the proposed project.)

DETAILS OF OFFEROR’S INVOLVEMENT IN THE PERFORMANCE OF THE PROJECT: (Include whether your firm participated as a prime, subcontractor, or joint-venture, and state percentage performed and whether performed as subcontractor or prime. Specifically describe your roles and responsibilities in the design/construction portion of the project and specific tasks accomplished that are similar to the solicitation requirement.

http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/02.htm#P10_600 http://farsite.hill.af.mil/reghtml/regs/far2afmcfars/fardfars/far/03.htm#P41_5833

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