Attachment_2-_Past_Performance_Survey.doc
DOC document 37 KB Posted
- Attached to
- Aerial Herbicide App, Ernest F. Hollings NWR, SC
- Solicitation number
- 140FS323Q0198
About this file
This document contains a past performance survey template for contractors to submit references on prior federal contracts along with details of a related federal contract opportunity posted by the Department of the Interior Fish and Wildlife Service. The opportunity is for aerial herbicide application services at the Ernest F. Hollings National Wildlife Refuge in South Carolina. Contractors are required to provide information on two prior relevant contracts they have completed, including contracting agency, point of contact, contract number, value, scope of work, role, any subcontracting, period of performance, completion dates, and details on quality control. The federal contract opportunity has a solicitation number of 140FS323Q0198 and is seeking herbicide application services at the specified refuge in South Carolina.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment_1-_Scope_of_Work.pdf | ||
| Sol_140FS323Q0198.pdf | ||
| Attachment_3-_Quote_Schedule.docx | DOCX document |
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
ATTACHMENT 2
GSA RFQ page 4 of 4
GSA CONTRACTOR---PAST PERFORMANCE SURVEY
Your Company Name:
Street Address:
City, State and ZIP Code:
1. GENERAL BUSINESS INFORMATION
Date Firm Organized/Established:
Company President:
Vice President:
UEI:
Is company a ; Sole Propriety [ ] Partnership [ ] Corporation [ ] Division [ ] N/A [ ]
2. GSA INFORMATION
A. GSA Contract Number:
Order Limits? Minimum
Maximum
B. Do you have a servicing office in the service/delivery location? Yes___ No ____
If yes;
Address: _______________________________________
Local POC Name: _________________________
Local POC Phone: ________________________
3. CONTRACTS/SUBCONTRACTS COMPLETED OR IN PROGRESS
Complete and submit the information requested on page 2-3 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:
Were You Terminated?
Did you use a Quality Control Plan? _________ Quality Control Problems encountered (if any):
How were the problems resolved?
b. Second 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:
Were You Terminated?
Did you use a Quality Control Plan? _________ Quality Control Problems encountered (if any):
How were the problems resolved?
4. Certification of Past Performance Information:
Type or Print Information
Name of Survey Preparer_______________________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
File details come from the government source that posted it. Updated .