Project Example Form

Judicial Council of California

Administrative Office of the Courts

ATTACHMENT 5

PROJECT EXAMPLE FORM

Proposers are to provide a list of project examples, in the format provided below, in accordance with the submittal requirements set forth in RFP Section IV, Proposal Submittal and Format Instructions. Indicate when an example is to demonstrate the proposer’s and/or a key personnel’s specialized experience/technical competence.

The AOC may contact some or all of the project examples provided in order to determine the proposer and key personnel’s technical competence and specialized experience. The AOC reserves the right to contact examples other than those provided in the response and to use the information gained from them in the evaluation process.

Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):
Project Example No.: / To Demonstrates Expertise of either Proposer and/or Key Personnel:
Name of Client for this Example: / Location of Client:
Project Description: / Identify Key Project Personnel for this Example(name, title, employer at time of project performance, project responsibility – Place an asterisk (*) by the name of anyoneproposed similar work for this RFP):
Project’s Contract Price: / Dates of Service for Example:
Project References (name, organization, title, telephone, email - Please ensure information is current.):

END OF FORM

Workers’ Compensation TPA Program Consolidation, RFP No. HR 0502

Attachment 5, Project Example Form

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