Attachment_4-_Past_Performance_Data_Document.docx

DOCX document 47 KB Posted

Attached to
Herbicide Application, Pee Dee NWR, NC Federal contract opportunity
Solicitation number
140FS326Q0156
Issued by
Department of the Interior Fish and Wildlife Service

About this file

This is a Past Experience & References Questionnaire template designed to evaluate contractor capability and qualifications for federal contract opportunities.

The document requires bidders to provide comprehensive information about their business background, including company registration details (name, SAM Unique Entity ID, address, and point of contact information), years of experience in services and federal contracting (both as prime and subcontractors), and disclosure of any failures to complete awarded work. Contractors must identify key personnel available for the project, including minimum and maximum employee counts, anticipated labor allocation, and detailed experience for each employee assigned to perform contract work. The questionnaire mandates submission of three contract references from work completed within the past three years that are similar in size and complexity to the solicitation's scope of work, with government contracts preferred. For each reference, contractors must provide the contracting agency or company name, contract number, total contract value, point of contact information with telephone and email, contract dates, and a detailed scope of project description sufficient for government evaluation. The form includes a certification statement requiring the contractor to attest that all information is complete and correct, and that named references are authorized to provide verification information to the government. Completion and submission of all requested information is mandatory for proposal compliance.

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Other files for this federal contract opportunity

Other files attached to Herbicide Application, Pee Dee NWR, NC, newest first.
File Type Posted
Attachment_1-_Performance_Work_Statement.pdf PDF
Attachment_2-Quote_Schedule.docx DOCX document
Attachment_3-_SCA_Wage_Determination.pdf PDF
Sol_140FS326Q0156.pdf 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

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 .