Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- CT-FWS STEWART B MCKINNEY-PESTICIDE
- Solicitation number
- 140FS325Q0066
About this file
The Past Performance Survey is a document designed for contractors to provide detailed information about their previous contract work, specifically for a Department of the Interior Fish and Wildlife Service solicitation (140FS325Q0066) related to a pesticide project. The survey requires comprehensive reporting on up to three contracts, including general business information, contract details, performance metrics, and company structure.
The survey captures critical performance data such as contract amount, role (prime, joint venture, or subcontractor), project scope, period of performance, completion status, subcontracting details, and quality control/safety plan implementation. Contractors must provide contact information, contract numbers, project locations, percentage of work completed, and attest to any terminations or quality/safety issues encountered. The document serves as a mechanism for the government to assess a company's past performance and capabilities before awarding the Stewart B. McKinney pesticide-related contract.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FS325Q0066.pdf | ||
| B08_-_SoW__2_Swallow-wort_Chimon_Treatment_2025.pdf | ||
| B03_-_Service_Contract_Act_WD___2015-4113.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 Identifier (UEI):
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__________________________________________
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