Attachment_2_Past_Performance_Survey.pdf
PDF 199 KB Posted
- Attached to
- Water Control Structures, Merrit Island, FL Federal contract opportunity
- Solicitation number
- 140FS326Q0025
About this file
This is a Past or Present Performance Survey form used to document a company's contract history and performance record. The form requests comprehensive information about the responding company, including its name, address, organizational details, UEI number, and small business status.
The survey requires companies to provide detailed information on up to three completed or in-progress contracts or subcontracts, with preference given to government contracts. For each contract, respondents must document the contracting agency or company name, point of contact, contract number, project title and location, general scope of work, and the company's role (prime contractor, joint venture partner, or subcontractor). Additional required details include the contract amount, subcontract amounts, period of performance, scheduled and actual completion dates, percentage of work completed, termination status, and whether quality control and safety plans were implemented. The form also requires documentation of any quality control or safety problems encountered and how they were resolved. The final page includes a certification section requiring the survey preparer's name, phone number, email address, title, signature, and date. This template serves as a standardized mechanism for companies to demonstrate their past performance history to prospective federal contracting agencies.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment_1_Need_and_Specifications_Water_Control_Structures.pdf | ||
| Sol_140FS326Q0025.pdf |
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Text version
ATTACHMENT 2 page 1 of 5
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.
http://www.sam.gov/
Telephone Number:
Contract/Subcontract Amount: $ _____
ATTACHMENT 2
a. First Contract:
Contracting Agency or Company:
Point of Contact:
Contract Number:
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?
Contract/Subcontract Amount: $ _____
ATTACHMENT 2
b. Second Contract:
Contracting Agency or Company:
Point of Contact:
Contract Number:
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):
Contract/Subcontract Amount: $ _____
ATTACHMENT 2
c. Third Contract:
Contracting Agency or Company:
Point of Contact:
Contract Number:
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):
ATTACHMENT 2 page 5 of 5
4. Certification of Past Performance Information:
Type or Print Information
Name of Survey Preparer _______________________________
Phone:__________________________ E-Mail;___________________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
| PAST OR PRESENT PERFORMANCE SURVEY |
| 1. GENERAL BUSINESS INFORMATION |
| 2. CONTRACTS/SUBCONTRACTS COMPLETED OR IN PROGRESS |
File details come from the government source that posted it. Updated .