Attachment 1 - Past Performance Questionnaire Form.pdf
PDF 171 KB Posted
- Solicitation number
- 47QACA26Q0422
- Issued by
- Not on record
About this file
This is a GSA Past Performance Questionnaire template designed for contractors and offerors to document their relevant experience on federal contracts as part of proposal submissions.
The form requires contractors to provide comprehensive contract information across four main sections. Section 1 captures basic contractor details including firm name, address, contact information, phone number, and UEI number. Section 2 identifies the contractor's role (prime contractor, subcontractor, joint venture, or other) and the percentage of project work performed, with subcontractors required to identify the prime contractor. Section 3 requests detailed contract information including contract number, contracting agency, contract type (firm fixed price, cost reimbursement, or other), contract title and location, award date, scheduled completion date, and actual completion date with explanations for any variances. The section also requires the original contract price and final contract price including all modifications, with explanations for any differences. Section 4 requests a project description including complexity level (high, medium, or routine) and a detailed explanation of how the project is relevant to the current solicitation, including similar equipment, requirements, and conditions. The instructions specify that offerors submit the completed questionnaire with their proposal, and the government reserves the right to verify all information provided on the form.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
PAST PERFORMANCE QUESTIONNAIRE
CONTRACT INFORMATION (Contractor/Offeror to complete Blocks 1-4)
1. CONTRACTOR/OFFEROR INFORMATION
Firm Name:
Address:
Phone Number: UEI Number:
Contact Name
Email Address: : Contact Phone Number:
2. GENERAL WORK INFORMATION
Work performed as: Prime Contractor Sub Contractor Joint Venture Other (Please explain):
Percent (%) of project work performed:
If a subcontractor, who was the prime (Name/Phone #):
3. CONTRACT INFORMATION
Contract Number:
Contract Agency:
Delivery/Task Order Number (if applicable):
Contract Type: Firm Fixed Price Cost Reimbursement Other (Please explain)
Contract Title:
Contract Location:
Award Date (mm/dd/yy):
Contract Completion Date (mm/dd/yy):
Actual Completion Date (mm/dd/yy):
Explain Differences:
Original Contract Price (Award Amount):
Final Contract Price (to include all modifications, if applicable):
Explain Differences:
4. PROJECT DESCRIPTION
Complexity of Work: High Med Routine
How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)
INSTRUCTIONS FOR CLIENTS COMPLETING THIS QUESTIONNAIRE: The offeror will submit the completed questionnaire to GSA with their proposal.The government reserves the right to verify any and all information on this form.
File details come from the government source that posted it. Updated .