Attch4_RelevantExperienceSurvey_4pp.docx
DOCX document 25 KB Posted
- Attached to
- NM BITTER LAKE NWR ELECTRIC & ROOF
- Solicitation number
- 140FGA26Q0071
About this file
This is a Past or Present Relevant Experience Survey form that contractors must complete to demonstrate their qualifications for federal contract opportunities. The form requests company general business information including the firm's organization date, company leadership, and SAM.gov Unique Entity ID. It requires documentation of up to three completed or in-progress contracts or subcontracts, whether government or commercial, with detailed information on each including the contracting agency or company name, point of contact, telephone number, contract number, contract amount, project title and location, general scope of work, and the contractor's role as prime, joint venture partner, or subcontractor.
For each contract listed, the form requires specification of subcontracted work and amounts, period of performance, scheduled and actual completion dates, and percentage of work completed. Contractors must also disclose whether they experienced termination, indicate whether they implemented quality control and safety plans, describe any quality control or safety problems encountered, and explain how those problems were resolved. The form concludes with signature blocks for the survey preparer, including name, phone number, email address, title, signature, and date, along with a certification statement regarding the accuracy of past performance information provided.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FGA26Q0071_Amd_0001.pdf | ||
| Attch2_B03_WD_DBA-NM20260014_ChavezCo-260518_4pp.pdf | ||
| Attch1_A04_SOW_Revised260819_10pp.pdf | ||
| Sol_140FGA26Q0071.pdf | ||
| Attch3_BidSchedule_1p.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
PAST OR PRESENT RELEVANT EXPERIENCE
Your Company Name:
Street Address:
City, State and ZIP Code:
1. GENERAL BUSINESS INFORMATION
Date Firm Organized/Established:
| Company President: | Vice President: | |
| SAM.gov Unique Entity ID: | ___________________ |
Is company a ; Partnership [ ] Separate entity [ ] Division [ ] N/A [ ]
2. CONTRACTS/SUBCONTRACTS COMPLETED OR IN PROGRESS
Complete and submit the information requested 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:
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): $
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: % Were You Terminated?
Quality Control or Safety Problems encountered (if any):
How were the problems resolved? _____
c. Third 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): $
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: % Were You Terminated?
Quality Control or Safety Problems encountered (if any):
How were the problems resolved? _____
Type or Print Information Name of Survey Preparer
Phone:_ E-Mail;_ Title Signature Date )4. Certification of Past Performance Information:
File details come from the government source that posted it. Updated .