Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- Roof work - MA Federal contract opportunity
- Solicitation number
- 140FC225R0004
About this file
This is a Past Performance Survey template form used to collect information about a contractor's previous contract experience. The form requires details on up to three previous contracts, including contract numbers, amounts, points of contact, and performance information. For each contract, contractors must specify their role (prime, joint venture, or subcontractor), describe subcontracted work, provide performance periods, completion dates, and indicate whether quality control and safety plans were used. The form also asks about any quality control or safety problems encountered and their resolutions. The template is associated with a Department of Interior Fish and Wildlife Service solicitation (140FC225R0004) for roof work in Massachusetts, though the survey itself is a standard form not specific to the roofing project.
The form requires basic business information including company organization details, leadership, and SAM.gov Unique Entity ID. It concludes with a certification section requiring the preparer's name, contact information, title, and signature. While this is a template document, it serves as a tool for evaluating contractor past performance as part of the broader roof work solicitation process.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140FC225R0004_Amd_0002.pdf | ||
| B09_Quote_Schedule_Revised_amd2_0002.pdf | ||
| B09_SOW_Revised_amd2_0002.pdf | ||
| Q_A_0001.docx | DOCX document | |
| Sol_140FC225R0004_Amd_0001.pdf | ||
| B08_SOW.pdf | ||
| B03_Wages.pdf | ||
| Sol_140FC225R0004.pdf | ||
| B08_Quote_Schedule.pdf |
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Text version
PAST OR PRESENT PERFORMANCE SURVEY
Your Company Name:
Street Address:
City, State and ZIP Code:
1. GENERAL BUSINESS INFORMATION
Date Firm Organized/Established:
Company President:
Vice President:
SAM.gov Unique Entity ID:
Is company a ; Partnership [ ] Separate entity [ ] Division [ ] N/A [ ]
2. CONTRACTS/SUBCONTRACTS COMPLETED OR IN PROGRESS
Complete and submit the information requested on page 2-4 below on prime contracts or subcontracts completed or in progress. Government contracts are preferred; but, if you have not performed Government contracts, indicate any other contracts completed or in progress.
a. First Contract:
Contracting Agency or Company:
Point of Contact:
Telephone Number:
Contract Number:
Contract/Subcontract Amount: $
Project Title and Location:
General Scope of Project:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
Describe any Work You Subcontracted to Others:
Total Amount of Subcontract(s): $
Period of Performance: days Scheduled Completion Date:
Actual Completion Date:
Percentage of Work Completed:
Were You Terminated?
Did you use a Quality Control Plan? _________ Did you use a Safety Plan?_______________
Quality Control or Safety Problems encountered (if any):
How were the problems resolved?
b. Second Contract:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
c. Third Contract:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
4. Certification of Past Performance Information:
Type or Print Information
Name of Survey Preparer _______________________________Phone:_________________
E-Mail;___________________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
File details come from the government source that posted it. Updated .