Attachment D - Construction and Design Experience Project Data Sheet

ATTACHMENT D

CONSTRUCTION & DESIGN EXPERIENCE PROJECT DATA SHEET

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

FORMCHECKBOX DESIGN #1 FORMCHECKBOX DESIGN #2 FORMCHECKBOX DESIGN #3 FORMCHECKBOX DESIGN #4 FORMCHECKBOX DESIGN #5 1. Experience for: FORMCHECKBOX Offeror FORMCHECKBOX Joint-Venture FORMCHECKBOX Other (Explain)

Firm Name:
Address:
Phone Number:
Unique Entity Identifier (UEI) Number:
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):

Complete Block 7 for Construction Projects. Complete Block 8 for Design Projects.

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. Design Project:

A-E Design Fee: Total Construction Value:
Type of Contract/Task Order: (Check ALL that apply)
FORMCHECKBOX Design-Build FORMCHECKBOX RFP Development FORMCHECKBOX Designer of Record FORMCHECKBOX Engineering Services FORMCHECKBOX Full Plans & Specs

FORMCHECKBOX Other (explain):
9. 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), including any sustainable features or Third Party sustainable certifications. If design-build, include a description of the design-effort.

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

11. Other Information: