Attachment 1: MACC Construction Experience Sheet

ATTACHMENT “1”

CONSTRUCTION EXPERIENCE PROJECT DATA SHEET – OFFEROR

This form is to be completed by the Offeror. Submit (one per project) in order to provide supporting project information for Factor 1, subfactor 3, Construction Experience. Only projects that are within the project description parameters of the solicitation will be considered relevant. Submit total of 4 projects. All other projects will not be considered. A Page 2 can be used if information will not fit in blocks provided below. Project No. (check one): FORMCHECKBOX - 1 FORMCHECKBOX - 2 FORMCHECKBOX - 3 FORMCHECKBOX - 4 Contractor:
1.
Offeror Name:

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Firm who performed the work:

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Performed this work as:
FORMCHECKBOX Prime Contractor FORMCHECKBOX Joint Venture FORMCHECKBOX Other (explain):

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If the firm who performed this project differs from the Offeror proposing on this contract, identify the firm’s relationship to the Offeror: FORMCHECKBOX Joint Venture Partner FORMCHECKBOX Partner FORMCHECKBOX Subsidiary
FORMCHECKBOX Parent Company
FORMCHECKBOX Affiliate
FORMCHECKBOX Predecessor Company

FORMCHECKBOX Other: FORMTEXT

Construction Contract:
2.
Contract/Project No.:

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Delivery/Task Order Number:

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Title:

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Location:

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Brief Project Description:

3.
Award Date (mm/dd/yy):

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Award Amount: $

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Completion Date (mm/dd/yy):

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Current/Final Amount: $

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4.
Type of Contract:
FORMCHECKBOX Design-Build. If D-B, design firm was:

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(check one)
FORMCHECKBOX Design-Bid-Build
Customer:
5.
Name:

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Point of Contact Name/Title:

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POC Phone Number:

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POC Email Address:

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Project Description:
6. Type of Work (check all that apply): FORMCHECKBOX New Construction FORMCHECKBOX Renovation/Repair 7. Type of Project: (check all that apply):
☐Biomedical Research Laboratory
☐Health Care Facility/Hospital
☐Animal Care Facility
☐Predominantly Utility Project
☐Renovation/Repair