Attachment 4 - Past Performance Reference List.pdf

339 KB Posted

Attached to
Refuse & Recycling
Solicitation number
FA301025R0021
Issued by

About this file

Written by GovTribe AI ·

This document is Attachment 4, a contract performance reference form for a Refuse & Recycling solicitation (FA301025R0021). The two-page template is designed for contractors to document their past performance, with columns for contract number, description of work performed, contract period, contracting agency details, contract value, and whether work was performed by subcontractors or key personnel. The first page provides space for multiple contract entries, while the second page allows detailed explanation of subcontractor, teaming arrangement, or key personnel involvement, including their specific function, task, and percentage of work completed or anticipated. The form appears intended to help offerors comprehensively demonstrate their relevant experience and capability for a federal refuse and recycling contract opportunity.

View the file

Other files

File Type Posted
Attachment 3 - Government Furnished Property List - Revised .pdf PDF
Solicitation Amendment FA301025R00210001 SF 30.pdf PDF
Attachment 1 - Performance Work Statement - 20250822.pdf PDF
Pre-Bid Site Visit Questions and Answers.pdf PDF
Site Visit Sign In Sheet - FA301025R0021.pdf PDF
Solicitation - FA301025R0021.pdf PDF
Attachment 3 - Government Furnished Property List.pdf PDF
Attachment 2 - WD 2015-5147 Rev 27 - 20250708.pdf PDF
Attachment 1 - Performance Work Statement - 20250730.pdf PDF
Attachment 5 - Past Performance Questionnaire (PPQ).pdf PDF

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

ATTACHMENT 4

FA301025R0021 Refuse & Recycling

1 | P a g e

COMPANY NAME:

CONTRACT NUMBER

(task order number(s) required if referencing an IDIQ contract)

Identify if CPAR is available

DESCRIPTION OF WORK PERFORMED

(performed as a prime/sub-contractor)

CONTRACT PERIOD OF

PERFORMANCE (POP)

CONTRACTING AGENCY,

POC/CUSTOMER NAME,

PHONE #, & EMAIL

CONTRACT/

TASK ORDER

VALUE

PERFORMED BY A PROPOSED

SUBCONTRACTOR, KEY

PERSONNEL, OR TEAMING

ARRANGEMENT? (if yes, complete page 2)

Use this space to provide additional information such as comments on any performance deemed unacceptable to customer, or not in accordance with the contract terms and conditions, etc. If additional information is provided for more than 1 contract, identify comments by contract number. Use multiple sheets if necessary.

ATTACHMENT 4

FA301025R0021 Refuse & Recycling

2 | P a g e

CONTRACT NUMBER

(task order number(s) required if referencing an IDIQ contract)

SUBCONTRACTOR,

TEAMING

ARRANGEMENT, OR

KEY PERSONNEL

DESCRIBE FUNCTION/TASK/3rd PARTY AFFECT ON PERFORMANCE (See Section L, answer all questions pertaining to subcontractor, teaming arrangement, or key personnel; indicating affect they had and percentage completed on referenced contract listed on page 1, and affect they will have and percentage they will complete while performing this contract)

CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow1:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow1:
CONTRACT PERIOD OF PERFORMANCE POPRow1:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow1:
CONTRACT TASK ORDER VALUERow1:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row1:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow2:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow2:
CONTRACT PERIOD OF PERFORMANCE POPRow2:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow2:
CONTRACT TASK ORDER VALUERow2:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row2:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow3:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow3:
CONTRACT PERIOD OF PERFORMANCE POPRow3:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow3:
CONTRACT TASK ORDER VALUERow3:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row3:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow4:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow4:
CONTRACT PERIOD OF PERFORMANCE POPRow4:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow4:
CONTRACT TASK ORDER VALUERow4:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row4:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contract Identify if CPAR is availableRow5:
DESCRIPTION OF WORK PERFORMED performed as a primesubcontractorRow5:
CONTRACT PERIOD OF PERFORMANCE POPRow5:
CONTRACTING AGENCY POCCUSTOMER NAME PHONE EMAILRow5:
CONTRACT TASK ORDER VALUERow5:
PERFORMED BY A PROPOSED SUBCONTRACTOR KEY PERSONNEL OR TEAMING ARRANGEMENT if yes complete page 2Row5:
Use this space to provide additional information such as comments on any performance deemed unacceptable to customer or not in accordance with the contract terms and conditions etc If additional information is provided for more than 1 contract identify comments by contract number Use multiple sheets if necessary:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow1:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow1:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow1:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow2:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow2:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow2:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow3:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow3:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow3:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow4:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow4:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow4:
CONTRACT NUMBER task order numbers required if referencing an IDIQ contractRow5:
SUBCONTRACTOR TEAMING ARRANGEMENT OR KEY PERSONNELRow5:
DESCRIBE FUNCTIONTASK3rd PARTY AFFECT ON PERFORMANCE See Section L 2d through 2g answer all questions pertaining to subcontractor teaming arrangement or key personnel indicating affect they had and percentage completed on referenced contract listed on page 1 and affect they will have and percentage they will complete while performing this contractRow5:
2 P a ge:
Text1:

File details come from the government source that posted it. Updated .