Past Performance Questionaire.pdf
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- Solicitation number
- N0016426Q0003
About this file
This document is an Attachment Past Performance/Experience Questionnaire for Solicitation #N0016426Q0003 issued by NSWC Crane. The form requires potential contractors to provide detailed information about their business and contracting experience, including years of work in the relevant field, past project history, and current contractual commitments.
The questionnaire requests contractors to list projects completed in the last three years, ongoing contractual commitments, and answer specific qualifying questions about past performance, such as whether they have ever failed to complete awarded work or had work completed by performance bond. Contractors must provide company details including DUNS number and CAGE code, business type, and years of experience as a prime or sub-contractor. The form concludes with a certification section where the contractor's authorized representative must sign and verify the accuracy of the submitted information.
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ATTACHMENT PAST PERFORMANCE/ EXPERIENCE QUESTIONNAIRE
EXPERIENCE QUESTIONNAIRE
Instructions: Complete by inserting information or Xing box, as indicated. If extra space is needed to complete an item, use the remarks block (indicate item number in remarks block).
1. Contractor Name, Address, and Telephone Number DUNS Number:
CAGE Code:
2. Submitted to (Office Name & Address)
– Attn: Kelsey Strunk NSWC Crane RE: Solicitation# N0016426Q0003
3. Business Company ��Partnership �Corporation �Individual Non-profit Organization �
4. How many years do you or your firm have in the line of work contemplated by this solicitation? ________ Years
5. How many years experience in contracting have you or your business had as a (a) prime contractor ________ and/or (b) sub-contractor ______ for same/similar services.
6. List below the projects your business has completed within the last three years (continue on separate sheet if necessary):
Contract Amount
Type of Project Date Completed Name, Address, and Telephone No. of Owner/Person to Contract for Project Information
7. List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation (continue on separate sheet if necessary):
Contract Amount
Dollar Amt Of Award
Name, Address, and Telephone No. of Business/Government Agency Involved
Awarded (Units)
Percent Completed
Date Contract
Completed
8a. Have you ever failed to complete any work awarded to you? _____ Yes _____ No 8b. Has work ever been completed by performance bond? _____ Yes _____ No 8c. If “Yes” to either item 8a or 8b specify location(s) and reason(s) why (continue on separate sheet if necessary):
CERTIFICATION
I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish NSWC Crane with any information needed to verify my capability to perform this project.
9a.Certifying Official’s Name and Title
9b. Signature (Sign in Ink) 10. Date kelsey.strunk Highlight
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