Attach_3_Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- 80KW GENERATOR REPLACEMENT CRYSTAL RIVER, FLORIDA Federal contract opportunity
- Solicitation number
- 140FS324R0025
About this file
This document is a Past Performance Survey to be completed by a company providing information on up to three recent contracts or subcontracts. The survey requests details such as the contracting agency, contract number, project scope, the company's role (prime, joint venture, or subcontractor), period of performance, quality control and safety plans used, and any problems encountered. The survey also asks for certification of the information provided by the survey preparer.
The related federal contract opportunity is for the replacement of an 80kW generator serving the Crystal River National Wildlife Refuge headquarters office in Florida. The solicitation number is 140FS324R0025, and the agency is the Department of the Interior Fish and Wildlife Service. A site visit is scheduled for September 3, 2024 at 9:30 AM ET.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attach_1_Crystal_River_NWR_Generator_SOW_Aug_2024.pdf | ||
| Attach_2_Service_Contract_Act_Wage_Determination_requirements.pdf | ||
| Sol_140FS324R0025.pdf |
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Text version
ATTACHMENT 3
PAST OR PRESENT PERFORMANCE SURVEY
Your Company Name:
Street Address:
City, State/Territory and ZIP Code:
1. GENERAL BUSINESS INFORMATION
Date Firm Organized/Established:
Company President:
Vice President:
WWW.SAM.GOV UEI Number:_______________
Is company a small business? YES [ ] NO [ ] 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 .