B08_Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- Electrical Services - VA Federal contract opportunity
- Solicitation number
- 140FC224Q0004
About this file
This document is a past performance survey template for contractors to provide information on previous federal contracts and subcontracts. It requests details on the contractor's general business including organization date, leadership, and SAM registration. Contractors are asked to provide specifics on up to three past prime contracts or subcontracts, including contracting agency, point of contact, contract number, value, title, scope of work, role (prime or subcontractor), any subcontracted work, period of performance, completion dates (scheduled and actual), percentage completed, quality control and safety plans used, and any problems encountered and how resolved. At the end, the survey requests a certification of past performance information be signed and dated. The related federal contract opportunity is for electrical services for the Department of Interior Fish and Wildlife Service under solicitation number 140FC224Q0004.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140FC224Q0004_Amd_0001.pdf | ||
| Q_A_0001.pdf | ||
| Sol_140FC224Q0004.pdf | ||
| Wages.pdf | ||
| SOW.docx | DOCX document |
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Text version
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 ID:
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 .