Attachment_0001_(revised)_Experience_Reporting_Form.pdf
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- Solicitation number
- W912DY-17-R-0028
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This document provides an Experience Reporting Form template to be completed by offerors responding to solicitation number W912DY-17-R-0028 for Medical Facilities Support Services IIa from the Department of the Army Corps of Engineers Engineering Support Center Huntsville. Offerors must use the form to describe up to seven relevant past projects demonstrating experience providing similar medical facility support services within the last five years. For each project, offerors must provide the contract number and location, type of contract and pricing, types of services performed, reference contact information, explanation of relevance to this solicitation, role on the contract as prime contractor, joint venture or subcontractor, value of work performed, detailed description of self-performed work and percentage of total cost, description of any subcontracted work including names and values of subcontractors, contract dates, and explanations for any cure letters or terminations/liquidated damages assessed.
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ATTACHMENT 0001 (Revised)
EXPERIENCE REPORTING FORM (ERF)
ERF Form No. of (e.g. 1 of 7)
Provide the following information to identify projects your company completed within the last five years that show experience with projects of similar type and scope. Use one form per project.
a. Name of Offeror:
b. Contract Number, Title and Location of Project:
c. Contract Type and Pricing Arrangement:
d. Type of Service/s Performed
e. Reference (Client) Contact Information (includes POC name, address, phone, and email address):
f. Describe how the contract referenced is relevant to the immediate acquisition. If only portions of the contract are relevant, specify which portions of the contract are relevant to the immediate acquisition:
g. Describe your Role (Prime, Joint Venture, or Subcontractor, etc.):
h. Your Contract or Subcontract Amount: ($)
i. Detailed Description of Your Self-Performed Work (include percentage of total cost):
j. Describe any Work You Subcontracted to Others (include names, addresses, and values):
k. Dates Your contract: Began: Completed:
l. Were you ever issued a Cure or Show Cause Letter?
yes no. If “yes”, provide explanation:
m. Were you Terminated or Assessed Liquidated Damages?
yes no. If “yes”, provide explanation:
File details come from the government source that posted it. Updated .