W9128A-19-R-0014_-_Section_00_22_16,_Attachment_A.docx

Attachment A

EXPERIENCE INFORMATION

(To be completed by Contractor) If the Offeror is in a Joint Venture, identify which contractor in the Joint Venture Completed the contract.

1. Contractor: Name:

Address:

DUNS:

CAGE Code:

2. Contract /Task Order(TO) /Purchase Order (PO) Number:

3. Contract/TO/PO Award Amount:

4. Contract/TO /PO Status: Period of Performance:

Original Completion Date: Percent Complete: ______%

Actual Completion Date (with time extensions):

Award Date:

Contract Title and Location (city, state):

Type of Contract (Design-Build, Design-Bid-Build, Work Plan Construct, Firm Fixed-Price, Cost Plus, etc.):

Contract Description-- to include the role of the contractor on the contract and specific responsibilities of the contractor in performance of the effort:

Type / scope of work performed by the Offeror:

Type / scope of work performed by Subcontractors:

Quality Awards, Letters of Appreciation, etc.

7. Project Owner or Project Manager for the Client – provide:

Name:

Address:

Telephone Number and E-mail:

W9128A-19-R-0014

* Section 00 22 16 – Attachment A – Page 1 * (Am-0001)

Section 00 22 16 – Attachment C – Page 2