Attachment 4 -Past Performance Questionnaire.pdf
PDF 131 KB Posted
- Attached to
- Monterey Ranger District Janitorial
- Solicitation number
- 127EAY26Q0060
- Issued by
-
Department of Agriculture Forest Service
About this file
This document is a USDA Forest Service Past Performance Questionnaire template used to evaluate contractor capability and track record for federal solicitations.
The questionnaire requires contractors to provide their business information, including company name, address, and telephone number, as well as business type classification (company, corporation, non-profit organization, co-partnership, or individual). Contractors must document their years of experience in the specific line of work relevant to the solicitation and detail their contracting experience as both prime contractors and subcontractors. The form requests a comprehensive list of projects completed within the last three years, including contract amounts, project types, completion dates, and owner/contact information for reference verification. Contractors must also disclose any instances of failure to complete awarded work, providing explanations if applicable. The questionnaire includes a certification section where the authorized official attests that all statements are complete and correct to the best of their knowledge, and authorizes the Forest Service to verify their capability through named references. References cited are FSH 6309.31 and 41 USC 1, indicating alignment with Forest Service Handbook procedures and federal contracting statute.
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Text version
USDA – Forest Service
PAST PERFORMANCE QUESTIONNAIRE
INSTRUCTIONS: See Box 11, Remarks, if extra space is needed to answer any questions below. Mark “X” in appropriate boxes.
1. CONTRACTOR NAME, ADDRESS, AND TELEPHONE NO.
2. SUBMITTED TO (office Name and Address)
3. BUSINESS
Company Co-partnership Corporation Individual Non-profit Organization
4. How many years do you or your firm have in the line of work contemplated by this solicitation?
5. How many years of experience in contracting have you or your business had as a (a) prime contractor and/or (b) sub-contractor ?
6. List below the projects your business has completed within the last three years:
CONTRACT
AMOUNT
TYPE OF PROJECT
DATE
COMPLETED
NAME, ADDRESS, AND TELEPHONE NO. OF
OWNER/PERSON TO CONTACT FOR PROJECT
INFORMATION
7a. Have you ever failed to complete any work awarded to you?
7b. If “Yes” to Item 8a type of project and reason(s) why:
Yes No
8. Remarks. Specify Box Numbers (Attach sheets if extra space is needed to fully answer any above question):
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any person named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.
9a. CERTIFYING OFFICIAL’S NAME AND TITLE
b. SIGNATURE (Sign in ink) 10. DATE
File details come from the government source that posted it. Updated .