Attachment C - Past Perfomance Questionnaire Mobile NC.pdf
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- Solicitation number
- QSE--36C78624Q50273
About this file
This document is a Past Performance Questionnaire for a federal contract opportunity. The questionnaire requires offerors to identify previous federal, state, local government, and/or private contracts that are similar in size and scope to the contract being evaluated. Offerors must provide details on at least three, but no more than five, contracts performed within the last three years. The contract opportunity is for Grounds Maintenance Services at the Mobile National Cemetery, with a base period plus four option years. The solicitation number is QSE--36C78624Q50273. The National Cemetery Administration, which is a part of the Department of Veterans Affairs, is the federal agency issuing the contract. The questionnaire requests information such as the name of the contracting company, contract number, type of contract, contract value, status of completion, and a description of the services provided, including complexity and the percentage of work completed by the prime contractor and any subcontractors.
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PAST PERFORMANCE QUESTIONNAIRE
INSTRUCTIONS: Offerors must identify previous federal, state, local government, and or private contracts completed and that are similar in size and scope to the contract being evaluated. List at least three (3), but no more than five (5) contracts performed within the last three (3) years. (One contract reference per form; Form may be duplicated)
NOTE: List any National Cemetery Administration (NCA) contracts currently working or previously worked first followed by Non-NCA contracts.
Contractor (you) Information:
Name: ______________________________________________________________________________
Address: ____________________________________________________________________________
Telephone Number: ___________________________________________________________________
E-mail: ______________________________________________________________________________
Contract Information:
Name of company/agency you provided service for: __________________________________________
Contract Number: ____________________________________________________________________
Type of Contract: _____________________________________________________________________
Contract Dollar Value: _________________________________________________________________
Date of Award: _______________________________________________________________________
Status: Completed, yes____ No____ If not completed, projected completion date___________________
If not completed, why? _________________________________________________________________
Were you the Prime? ________ were you the Sub? _______
Point of Contact Information for the company/agency you serviced:
Name of the Contract Person & their position: _______________________________________________
Address: ____________________________________________________________________________
Telephone Number: ___________________________________________________________________
E-mail: _____________________________________________________________________________
Description of Supply/Service(s) provided, location & relevancy of work:
Complexity of Product/Service, if any:
Percentage of Work completed by your company/by subcontractor: (If less than 100%, please explain the tasks you performed.)
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