Attachment_1_for_Section_00_22_16_Revised.docx

SECTION 00 22 16 - ATTACHMENT 1

OFFEROR or KEY SUBCONTRACTOR EXPERIENCE FORM

USE ONE FORM PER PROJECT

Note: A separate Word version of this document will be accessible on fedbizopps at fbo.gov

Provide the following information to show examples of projects your company constructed within the last seven (7) years indicating experience with recent and relevant projects.

1. Type of Construction Represented: ______________________________________________________

2. Name of Offeror: ____________________________________________________________________

3. Project Title: _______________________________________________________________________

4. Contract/Project Number: _____________________________________________________________

5. Project Owner and Location: ___________________________________________________________

6. Total Contract Value: $ _____________________________ (Final value if completed, current value if not completed)

7. If Offeror performed as Subcontractor, the $-value of Subcontract: $ ___________________________

8. Construction Phase Start Date (Month/Day/Year): __________________________________________

9. Original Construction Phase Completion Date (Month/Day/Year): _____________________________

10. Actual Construction Phase Completion Date (Month/Day/Year): _____________________________ (Actual date if project has been completed)

11. Name of Owner/Client POC: __________________________________________________________

12. Telephone Number of Owner/Client POC: _______________________________________________

13. Email Address of Owner/Client POC: ___________________________________________________

14. General Scope of Construction Project: __________________________________________________

ATTACHMENT 1 CONTINUED:

15. Describe/demonstrate how the project is relevant to the solicitation in the following areas, as stated in the Definitions:

(a) Scope: ________________________________________________________________________

(b) Magnitude of Effort: _____________________________________________________________

(c) Complexity:____________________________________________________________________

16. If applicable, explain how the project is relevant to the solicitation in the following areas, as defined in Factor 1:

(a) Military Operations Facility: ______________________________________________________

(b) Risk Category IV Facility:_________________________________________________________

(c) Building Information Modeling (BIM):______________________________________________

(d) Similar Geographic Location:______________________________________________________

(e) Concrete Grade Beam Supported by Drilled Concrete Pier Foundation:______________________

17. Describe your role and responsibility during construction of the project (indicate whether your firm performed as a prime or subcontractor and what percentage of work you self-performed and/or type of work you subcontracted out, if applicable):

18. Summarize your performance evaluation by Customer/Client, if known:

19. Were you issued a Cure Notice, Show Cause Letter, Terminated for Default and/or Assessed Liquidated Damages? (If “Yes” provide an explanation):