Attachment_3_Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- ST CATHERINE CRK NWR, MS REPLACE FUEL TANKS Federal contract opportunity
- Solicitation number
- 140FS325Q0151
About this file
The document is a Past Performance Survey form designed to capture detailed information about a company's contract history. The form requires companies to provide comprehensive details about up to three contracts, including contract agency, point of contact, contract number, contract amount, project title, scope, role (prime, joint venture, or subcontractor), work performed, subcontractor details, performance period, completion status, and quality control/safety plan information.
This specific document is associated with a federal contract opportunity from the Department of the Interior Fish and Wildlife Service for St. Catherine Creek National Wildlife Refuge in Mississippi. The solicitation involves replacing fuel tanks, specifically disposing of two existing 1,000-gallon Convault tanks and installing two new 550-gallon Fireshield above-ground horizontal double-walled steel tanks for diesel and gasoline dispensing. A site visit is scheduled for September 18, 2025, at 10:00 AM ET, located at 21 Pintail Lane in Natchez, Mississippi.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment_1A_Location_Map_and_Photos.pdf | ||
| Attachment_2_SCA_Wage_Determination_for_Adams_MS.pdf | ||
| Sol_140FS325Q0151.pdf | ||
| Attachment_1_Replacement_of_Tanks_SOW.pdf |
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Text version
ATTACHMENT 3
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.
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:
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?
b. Second Contract:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
c. Third Contract:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
4. Certification of Past Performance Information:
Type or Print Information
Name of Survey Preparer _______________________________
Phone:__________________________ E-Mail;___________________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
File details come from the government source that posted it. Updated .