4-Past Present.pdf

PDF 137 KB Posted

Attached to
Development of Safety Action Plan for the Village of Spring Valley
Solicitation number
RFP-VOSV-2026-001
Issued by
Rockland County, New York

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This is a Past and Present Performance Information Form for the Village of Spring Valley in New York, prepared by County Executive Edwin J. Day. The form is a template designed for offerors responding to RFP-VOSV-2026-001, which seeks proposals for the development of a Safety Action Plan for the Village of Spring Valley. The broader contract opportunity involves conducting a comprehensive traffic study of Village roadways to assess current traffic conditions, forecast future traffic patterns, and recommend improvements to enhance traffic flow, safety, and transportation efficiency. Offerors are required to submit this completed form as part of their technical proposal, with separate forms required for each contract or program submitted as a reference. The form requests detailed information about relevant past performance, including the original and current contract values, contract term dates, and the number of any change orders issued.

The form requires offerors to provide primary customer points of contact information for both the reference program or project manager and the contracting officer, with instructions to confirm that all contact information is current prior to submission. Offerors must identify whether they performed as prime contractors or subcontractors on the referenced projects and disclose the names and percentage of contract responsibility for any subcontractors utilized. Additionally, offerors must specify the names of key individuals who participated in past contracts and who are proposed to support the acquisition detailed in the RFP. The form emphasizes providing frank and concise comments regarding performance on identified contracts and requests information on the primary causes or reasons for any change orders issued during contract performance.

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Other files

File Type Posted
1-Appendix B Standard Terms Conditions for Service Contracts.pdf PDF
6-Statement of Disclosures.pdf PDF
3-FTA Clauses .pdf PDF
5-RFP-VOSV-2026-001 Safety Action Plan .pdf PDF
2-FEDERAL CONTRACT CLAUSE.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-VOSV-2026-001 Development of Safety Action Plan for the Village of Spring Valley

MoodieC Highlight

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:

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