Attach 5 - Past Perf Questionnaire (25RA002).pdf
PDF 201 KB Posted
- Attached to
- G1 - Non Clinical Case Management Services Federal contract opportunity
- Solicitation number
- W912L3-25-R-A002
About this file
This is a Past Performance Questionnaire form (Attachment 5) for RFP W912L3-25-R-A002, to be used for evaluating contractors' previous work experience. The form is marked "FOR OFFICIAL USE ONLY" and consists of two pages collecting detailed information about prior contracts.
The questionnaire requests information including: project name and location, contractor role (prime/sub/joint venture), project owner details, technical and contracting points of contact, contract type and scope, current status of work, start/completion dates, initial and final contract amounts, problems encountered and solutions, safety issues, and key personnel involved. The form includes sections for explaining any schedule delays or cost increases, and space for additional comments. It also requests attachment of relevant letters of appreciation for the referenced project. This questionnaire appears to be a template that would be completed separately for each past performance reference submitted by offerors.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| B.06 RFIs Answered (25-R-A002).xls | XLS spreadsheet | |
| B.06 RFIs Answered (25-R-A002).xls | XLS spreadsheet | |
| Attach 4 - RFP Instructions (25RA002).pdf | ||
| Attach 6 - Basis for Award (25RA002).pdf | ||
| RFIs Answered (25-R-A002).xls | XLS spreadsheet | |
| B.08 W912L325RA002 - G1 - Non Clinical Case Management Services.pdf | ||
| B.08 W912L325RA002 - G1 - Non Clinical Case Management Services.pdf | ||
| Attach 4 - RFP Instructions (25RA002).pdf | ||
| Attach 1 - PWS (25RA002).pdf | ||
| Attach 3 - Schedule B (25RA002).xlsx | XLSX spreadsheet | |
| Attach 6 - Basis for Award (25RA002).pdf | ||
| Attach 2 - WD 2015-5405 (25RA002).pdf |
Show all 12
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
FFOR OFFICAL USE ONLY
RFP W912L3-25-R-A002 ATTACHMENT 5-
PAST PERFORMANCE QUESTIONNAIRE
FOR OFFICAL USE ONLY
1.a. Project Name and Location: 1.b. Mark involvement for this project (Check the one that applies): (If other, describe in Block 26) Prime Contractor Sub-Contractor Joint Venture Other
2. Project owner’s complete address:
3a. Technical Point of Contact for project (Name, title, address, phone, fax, email):
4b. Contracting Point of Contact for the project (Name, title address, phone, fax, email):
4. Describe contract type (Service, etc), Nature and Scope of work:
4a. Current Status of Contract (Check the one that applies):
Work continuing, on schedule (must be greater than 50% complete) Work continuing, behind schedule Work completed, no further action pending Work completed, routine administrative action pending
Work completed, claims negotiation pending/underway Work completed, litigation pending/underway Terminated for convenience Terminated for default Other (explain in Block 26, Additional Comments)
5. Date work was begun (Day/Month/Year):
6. Date work was completed (Day/Month/Year):
Estimated Date of Completion: / / Actual Date of Completion*: / / *leave blank if project is ongoing
7. If actual completion date is later than initial completion date, explain why:
8. Initial contract price Amount for which Offeror was responsible:
$ _________________.00
9. Final invoiced amount (or amount invoiced to date) Amount for which Offeror was responsible:
$ _________________.00
10. If final invoiced amount greater than initial contract amount, explain why:
FFOR OFFICAL USE ONLY
RFP W912L3-24-R-1001
ATTACHMENT 5- PAST PERFORMANCE QUESTIONNAIRE
FOR OFFICAL USE ONLY
11. Project Name and Location:
12. Explain any problem(s) encountered, and solution to resolve problem(s):
13. Were there any safety problems or accidents? Explain:
Provide, based on the job description, the names of the following personnel that worked on this project in following positions:
Job Description: First Name, Last Name:
Status During Project
(Check the one that applies):
14. 14a. 14b. In-House Subcontractor
15b. In-House Subcontractor
16b. In-House Subcontractor
17. Additional Comments:
Please attach any Letters of Appreciation that apply ONLY to this project to this form.
File details come from the government source that posted it. Updated .