Attachment C- Construction Experience Project Data

ATTACHMENT C

CONSTRUCTION EXPERIENCE PROJECT DATA SHEET

Project No. (check one) : FORMCHECKBOX CON #1 FORMCHECKBOX CON #2 FORMCHECKBOX CON #3 FORMCHECKBOX CON #4 FORMCHECKBOX CON #5

1. Experience for: FORMCHECKBOX Offeror FORMCHECKBOX Joint-Venture FORMCHECKBOX Other (Explain)

Firm Name:
Address:
Phone Number:
UEI Number:
Cage Code:
Point of Contact: Contact Phone Number:
2. Work Performed as: FORMCHECKBOX Prime Contractor FORMCHECKBOX Sub Contractor FORMCHECKBOX Joint Venture FORMCHECKBOX Other (Explain)

Percent of project work performed:
If subcontractor, who was prime (Name/Phone #):

3. Contract Number: Delivery/Task Order Number:

Title:
Location:
4. Award Date (mm/dd/yy): Completion Date (mm/dd/yy):

5. Type of work:

FORMCHECKBOX New Construction FORMCHECKBOX Renovation FORMCHECKBOX Repair FORMCHECKBOX Alteration FORMCHECKBOX Other (explain):

6. Type of Contract/Task Order: (Check ALL that apply)

FORMCHECKBOX Firm-Fixed Price FORMCHECKBOX Cost/Time and Material FORMCHECKBOX Other (explain):

7. Construction Project:

Award Amount: Final Price:

Type of Contract/Task Order: (Check ALL that apply)

FORMCHECKBOX Design-Build FORMCHECKBOX Design-Bid-Build FORMCHECKBOX Delivery/Task Order (IDIQ) FORMCHECKBOX Other (explain):

8. Provide a detailed description of the project and the relevancy to the project requirements of this RFP (i.e.: unique features, square footage, construction methods). If design-build, include a description of the design-effort.

9. Provide a detailed description of what work your firm self-performed on this project:

10. Other Information: