B08_Past_Performance_Survey.pdf
PDF 127 KB Posted
- Attached to
- MN VLY NWR-HOGBACK LEVEE-FLOOD REPAIR
- Solicitation number
- 140FC226R0002
About this file
This is a Past or Present Performance Survey form designed to collect detailed information about a company's contract performance history for evaluation purposes in federal contracting.
The form begins with basic company information requirements including name, address, organization date, key personnel, Dun & Bradstreet number, and business structure (partnership, separate entity, division, or N/A). The primary focus of the survey is Section 2, which requests comprehensive details on up to three completed or in-progress prime contracts or subcontracts. For each contract, respondents must provide the contracting agency or company name, point of contact, telephone number, contract number, contract value, project title and location, and general scope of work. The survey requires specification of the company's role (prime contractor, joint venture participant, or subcontractor) and a detailed description of work performed. Additional required information includes the total amount of any subcontracted work, period of performance duration, scheduled and actual completion dates, percentage of work completed, termination status, and whether quality control and safety plans were implemented. The form also requests identification of any quality control or safety problems encountered and explanations of how such problems were resolved. The survey concludes with a certification section requiring the preparer's name, phone number, email address, title, signature, and date. Government contracts are preferred, though non-government contracts may be submitted if no government contract experience exists.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FC226R0002_Amd_0001.pdf | ||
| B08_Specs_Final.pdf | ||
| B08_MNV490_BIDSCHD_080425.docx | DOCX document | |
| B08_Wages.pdf | ||
| Sol_140FC226R0002.pdf | ||
| B08_DWG_SET_080525.pdf | ||
| B08_Summary_of_Work.pdf |
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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:
Dun & Bradstreet Number: __
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:
Point of Contact: Telephone Number:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: %
c. Third Contract:
Point of Contact: Telephone Number:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: %
4. Certification of Past Performance Information:
Type or Print Information
Name of Survey Preparer _______________________________Phone:_________________
E-Mail;___________________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
| PAST OR PRESENT PERFORMANCE SURVEY |
| 1. GENERAL BUSINESS INFORMATION |
| 2. CONTRACTS/SUBCONTRACTS COMPLETED OR IN PROGRESS |
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