Amendment R0004_Section 00 22 00_Attachment 1.docx
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- Attached to
- Department of Veteran’s Affairs American Lake (VAAL) Phase 2A Site Development at Lakewood, WA
- Solicitation number
- W912DW22R0004
About this file
This document contains an attachment for an offeror or key subcontractor experience form for the Request for Proposal Number W912DW22R0004 from the Department of the Army Corps of Engineers Engineering District Seattle. The RFP is for the Department of Veteran's Affairs American Lake (VAAL) Phase 2A Site Development at Lakewood, WA. It is a Service Disabled Veteran Owned Small Business (SDVOSB) Set-Aside, Design Bid Build (DBB) acquisition using Lowest Priced Technically Acceptable (LPTA) procurement. Offerors must submit the experience form as an attachment demonstrating relevant past performance on projects within the last six years, including information such as contract values, timelines, scopes of work, roles and responsibilities, and references. Details on minimum qualifications and evaluation criteria can be found in the RFP attachments.
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Text version
SECTION 00 22 00 - ATTACHMENT 1
OFFEROR or KEY SUBCONTRACTOR EXPERIENCE FORM
PLEASE USE THIS FORM PER SUBMITTED PROJECT
Factor 1 – Relevant Experience of Offeror Factor 2 – Relevant Experience of Team
Note: A separate Word version of this document will be accessible on SAM.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. Name of Offeror (Or Key Subcontractor):
2. Project Title:
3. Contract/Project Number:
4. Project Owner and Location:
5. Total Contract Value: $ (Final value)
6. If submitting project performed by a JV, provide the DUNS number, unique entity identifier from SAM.gov and Cage Code for each member:
7. Offeror acting as Subcontractor or performed as Key Subcontractor (Yes or No)
8. If Offeror performed as Subcontractor, the $-value of Subcontract: $
9. Construction Phase Start Date (Month/Day/Year):
10. Original Construction Phase Completion Date (Month/Day/Year):
11. Actual Construction Phase Completion Date (Month/Day/Year):
12. Name of Owner/Client POC:
13. Telephone Number of Owner/Client POC:
14. Email Address of Owner/Client POC:
15. General Scope of Construction Project:
ATTACHMENT 1 CONTINUED:
16. Describe/demonstrate how the project is relevant to the RFP in the following areas, as defined in Factor 1 and/or 2:
(a) Complexity:
(b) Magnitude/Cost:
(c) Scope:
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 the 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):
20. Submit at least one representative photo or drawing with labels or marking of the document noting the especially relevant areas (Factor 2 only).
W912DW22R0004 R0004
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