AMEND_0001_ATTACHMENT_1_TO_SECTION_00_22_16_-_FACTOR_A_EXPERIENCE_FORM.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

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 ten (10) 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) New construction of a pre-engineered building:________________________________________

(b) New construction or renovation of an aircraft facility within or contiguous to a Federal Government airfield:

(c) New construction of a facility with a deluge fire sprinkler system or a high temperature exhaust duct:__________________________________________________________________________

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):

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):