2-Past Present.pdf

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Attached to
Fuel Management Software and Dispensing Pumps
Solicitation number
RFP-RC-2026-017
Issued by
Rockland County, New York

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Written by GovTribe AI ·

This is a Past & Present Performance Information Form from the County of Rockland, New York, Department of General Services, Facilities Management Division, related to RFP-RC-2026-017 for Fuel Management Software and Dispensing Pumps. The procurement seeks proposals for the emergency replacement of an obsolete Gasboy TopKat fueling management software system that controls and monitors fuel dispensing pumps at two county locations: the Dr. Robert L. Yeager Health Center in Pomona, New York (two pumps) and 55 New Hempstead Road in New City, New York (one pump). Two additional fuel dispensing pumps located in New City will be replaced at a later date under separate procurement actions.

The form provided is a template designed for offerors to document their relevant past performance and experience on similar contracts. Offerors must complete the form by providing contract reference information, including the contracting entity name, original and current contract values, contract terms, change order history, primary customer and contracting officer contact information, identification of any subcontractors and their percentage of work, and names of key individuals proposed to support the acquisition. The form requires offerors to submit a separate completed form for each relevant contract, with submissions limited according to specifications outlined in the RFP.

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Other files

File Type Posted
1-Appendix B Standard Terms Conditions for Service Contracts.pdf PDF
5-RFP-RC-2026-017 Fuel Management Software and Dispensing Pumps.pdf PDF
4-Statement of Disclosures.pdf PDF
3-RFP-RC-2026-017 Federal Contract Clauses.pdf PDF

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Edwin J. Day, County Executive

PAST & PRESENT PERFORMANCE INFORMATION FORM

COMPLETE AND INCLUDE THIS FORM IN YOUR TECHNICAL PROPOSAL

NAME OF OFFEROR: __________________________________

Provide the information requested on this form for each contract/program being described as a reference. Provide frank, concise comments regarding your performance on the contracts you identify. Provide a separate completed form for each contract/program submitted. Limit the number of past efforts submitted and the length of each submission to the limitations, if any, set forth in specifications.

Name of Contracting Entity: ___________________________________ Contract Name/Title: __________________________________

Term of Contract: ____________________________

Original Contract Value: ________________________________ Current or Final Contract Value: _______________________________________

A. Brief Description of your effort. Identify whether you were a Prime or Subcontractor.

1. Original Date: ______________________________ 2. Current or Final Date: __________________________

3. Number of Change Orders (if any): ________________

Primary Causes or Reasons of Change: ________________________________________________________________________

B. Primary Customer Points of Contact:

NOTE: CONFIRM CONTACT INFORMATION PROVIDED IS CURRENT PRIOR TO SUBMISSION.

Reference Program/Project Manager:

Name:______________________________________________________

Address:____________________________________________________

Telephone: ______________________ Fax: _______________________

E-mail: _____________________________________________________

Reference Contracting Officer

Name:__________________________________________________

Address: _______________________________________________

Telephone: ___________________ Fax: ___________________

E-mail: _________________________________________________

C. If subcontractors were used, identify the names of the subcontractors and the percentage of the contract the subcontractor was responsible for. ____________________________________________________________________________________________

D. Specify, by name, any key individual(s) who participated in this contract and are proposed to support acquisition detailed in the RFP.

RFP-RC-2026-017 Fuel Management Software and Dispensing Pumps

RFP-RC-2026-017 Fuel Management Software and Dispensing Pumps

NAME OF OFFEROR:
Name of Contracting Entity:
Contract Name/Title:
Term of Contract:
Original Contract Value:
Current or Final Contract Value:
A:
1 Original Date:
3 Number of Change Orders (if any):
Primary Causes or Reasons of Change:
Primary Causes or Reasons of Change_1:
2 Current or Final Date:
2 Current or Final Date_1:
responsible for:
D:
D_1:
Name:
Address:
Telephone:
Fax:
E-mail:
Name_1:
Address_1:
Telephone_1:
Fax_1:
E-mail_1:

File details come from the government source that posted it. Updated .