Past_Experience_Questionnaire_1622755364278.doc
DOC document 36 KB Posted
- Attached to
- OK-OK ESFO-TSCS NEGOTIATIONS SUPPORT
- Solicitation number
- 140FNR25Q0014
About this file
The document is a Past Experience Questionnaire, a standard form used to collect detailed information about a company's previous contract performance. The template requires potential contractors to provide comprehensive details about up to three contracts, including agency/company name, contract number, contract amount, project scope, role (prime/subcontractor), performance period, and key performance metrics such as quality control and safety plans.
The questionnaire is specifically linked to a Department of the Interior Fish and Wildlife Service solicitation (Number: 140FNR25Q0014) for "OK-OK ESFO-TSCS NEGOTIATIONS SUPPORT". The form captures critical information about a company's past performance, including contact information, business structure, GSA contract status, subcontracting details, and performance challenges. Companies are expected to document their contract history, highlighting their capabilities, project management approach, and ability to successfully complete complex government contracts.
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Text version
PAST EXPERIENCE QUESTIONNAIRE
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
Does company have GSA contract? Yes / No
If so GSA contract(s) number:_________________________________________________
Is product offered on schedule? Yes / No Complete and submit the information requested on the next pages 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/Product Title and Delivery 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/Delivery Days: days Scheduled Completion/Delivery Date:
Actual Completion/Delivery Date:____
Were You Terminated?
Did you use a Quality Control Plan? _________ Did you use a Safety Plan?_______________ Delivery, 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 and Present Performance Information:
Type or Print Information
Name of Survey Preparer _______________________________
Phone:_________________ Email:______________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
File details come from the government source that posted it. Updated .