Word_Version_-_Attachment_1_for_Section_00_22_16.docx

SECTION 00 22 16 - ATTACHMENT 1

OFFEROR or KEY SUBCONTRACTOR EXPERIENCE FORM

USE ONE FORM PER PROJECT

COMPLETE THE APPLICABLE ITEMS FOR FACTOR A AND FACTOR B

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 six (6) 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: $ _____________________________

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: __________________________________________________

COMPLETE ONLY FOR FACTOR A – RELEVANT EXPERIENCE OF OFFEROR/PRIME:

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

(a) Complexity:____________________________________________________________________

(b) Function: ____________________________________________________________________

(c) Magnitude/Cost:_________________________________________________________________

(d) Similar:________________________________________________________________________

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

(a) U.S. Green Building Council LEED Silver Certification or Better:_________________________

(b) New Construction on U.S. Military Installation:_______________________________________

COMPLETE ONLY FOR FACTOR B – RELEVANT EXPERIENCE OF TEAM:

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

(a) Magnitude/Cost:_________________________________________________________________

(b) Scope: ________________________________________________________________________

(c) Similar:________________________________________________________________________

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

(a) Steel and Masonry Construction, Not Pre-Engineered, Not Prefabricated:___________________

(b) Mechanical Systems and Electrical Systems Similar to a 2 company fire station:_____________

(c) Long Span Structural Roof System:_________________________________________________

19. 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):

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

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