B08_-_ATTACHMENT_3_Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- MD-PATUXENT RSRCH REF-BPA SETUP-PROPANE
- Solicitation number
- 140FS324Q0072
About this file
This document is a past performance survey for a contractor responding to Solicitation 140FS324Q0072 for propane setup services at the Patuxent Research Refuge. The survey collects information on up to three past or present contracts including the contracting agency, point of contact, contract number, value, scope of work, role, subcontracting details, schedule, and performance issues. The responding contractor must provide details on quality control and safety plans used on past projects as well as any problems encountered and how they were resolved. The solicitation is for the Department of the Interior Fish and Wildlife Service for propane setup services at the Patuxent Research Refuge.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| B08_-_ATTACHMENT_1_Patuxent_Propane_Fuel_Quote_Schedule.doc | DOC document | |
| B08_-_ATTACHMENT_2_Patuxent_Research_Refuge_2024_Propane_Fuel__Statement_of_Work.doc | DOC document | |
| Sol_140FS324Q0072.pdf |
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Text version
ATTACHMENT 3
Solicitation F13PS00849 page 1 of 5
PAST OR PRESENT PERFORMANCE SURVEY
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 Identifier (UEI):
Is company a ; Partnership [ ] Separate entity [ ] Division [ ] 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 .