Attachment_3-_Past_Performance_Data_Document.docx
DOCX document 47 KB Posted
- Attached to
- 300 Gallon Tank, FWS Turnbull NWR, WA
- Solicitation number
- 140FS326Q0138
About this file
This is a Past Experience & References Questionnaire template that contractors must complete and submit with their proposal to demonstrate compliance with the solicitation requirements for contract opportunity 140FS326Q0138, a Request for Quotation (RFQ) issued by the U.S. Fish and Wildlife Service for a 300 Gallon Tank at Turnbull National Wildlife Refuge in Washington. The questionnaire requires companies to provide comprehensive information about their business experience, including years of service, contracting history, federal contract experience, and employee capacity to perform the work.
The form mandates submission of detailed past performance references from contracts completed within the past three years that are similar in size and complexity to the scope of work, with government contracts preferred. Respondents must document at least three contract references including agency/company name, contract number, total contract value, points of contact with phone and email, performance dates, and detailed scope descriptions. Additionally, contractors must certify their minimum and maximum employee availability, key personnel qualifications, history of failed projects, and whether employees are regularly on payroll. The template serves as an evaluation tool for the government to assess contractor capability and past performance prior to award, with the anticipated contract performance period beginning November 1, 2026. This is a 100% Small Business Set Aside under FAR Parts 12 and 13 with a NAICS code of 333111 (Farm Machinery and Equipment Manufacturing) and a small business size standard of 1,250 employees.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment_2-Quote_Schedule.docx | DOCX document | |
| Attachment_1-_Supply_Requirement.pdf | ||
| Sol_140FS326Q0138.pdf |
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Text version
PAST EXPERIENCE & REFERENCES QUESTIONNAIRE
**ALL INFORMATION MUST BE PROVIDED TO BE COMPLIANT WITH SOLICITATION**
Your Company Name:
SAM Unique Entity ID (UEI)#:
Street Address:
City, State and ZIP Code:
POC Name:
POC Phone Number:
POC Email:
Type of Business: Corporation Partnership Sole Proprietor Other (describe)
To receive consideration, complete and submit the information requested below with your proposal. If additional space is needed this form may be duplicated as necessary or you can provide your own form.
1) How many years’ experience does your business have in services? .
2) How many years’ experience in contracting has your business had as a Prime Contractor , or a Sub- contractor . How many of these years were performed for Federal Government Contracts .
3) Have you ever Failed to Complete any work awarded to you? Yes or No. If “yes” specify reasons why.
Past Experience Questionnaire – 140F0922Q0105 Page 1 of 2
4) Key Personnel Available for this Project:
a) Minimum # of Employees:
Maximum # of Employees:
b) Are employees regularly on your payroll? Yes or No
c) How many employee(s) do you anticipate to perform the work contemplated by this solicitation?
d) Are you a sole proprietor? Yes or No
e) If you are a Prime Contractor hiring a Sub Contractor, provide the name and location of the Sub Contractor: .
5) Employee Experience: Provide the below information for each employee(s) who will perform the work contemplated by this solicitation:
Present Position/Title: Years of Experience:
6) References and Relevant Past Performance/Experience:
Experience must have been completed within the past three (3) years and be similar in size and complexity to those stated in the Scope of Work. Government contracts are preferred; but, if you have not performed Government contracts, indicate any other contracts completed or in progress.
First Contract Reference:
Contract Agency or Company Name:
Contract Number (if applicable):
Total Contract $ Value:
Point of Contact (POC) Name:
POC Telephone #:
POC E-mail address:
Contract Start and End Date:
Scope of Project: (Sufficient detailed information must be provided for the Government to perform an evaluation)
Second Contract Reference:
Contract Agency or Company Name:
Contract Number (if applicable):
Total Contract $ Value:
Point of Contact (POC) Name:
POC Telephone #:
POC E-mail address:
Contract Start and End Date:
Scope of Project: (Sufficient detailed information must be provided for the Government to perform an evaluation)
Third Contract Reference:
Contract Agency or Company Name:
Contract Number (if applicable):
Total Contract $ Value:
Point of Contact (POC) Name:
POC Telephone #:
POC E-mail address:
Contract Start and End Date:
Scope of Project: (Sufficient detailed information must be provided for the Government to perform an evaluation)
7) Certification:
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the Government with any information needed to verify my business and employee’s capability to perform this project.
Certifying Official’s Name and Title: Date:
File details come from the government source that posted it. Updated .