Past_Experience_Questionnaire.doc
DOC document 36 KB Posted
- Attached to
- AL DEEP HORIZON NRDA & RESTOR AE. IMAGES Federal contract opportunity
- Solicitation number
- 140FNR25Q0019
About this file
The Past Experience Questionnaire is a detailed document designed to capture a company's historical contract performance and business information. The form requires comprehensive details about three previous contracts, including contracting agency, contract number, contract amount, project scope, company's role (prime, joint venture, or subcontractor), performance period, and quality/safety management practices.
The questionnaire requests key business information such as company establishment date, organizational structure, GSA contract status, and contact details. It provides space for documenting up to three contracts, with sections examining each contract's specifics like subcontracting details, performance dates, potential terminations, and any delivery, quality control, or safety challenges encountered. The document concludes with a certification section requiring the preparer's signature, contact information, and attestation to the accuracy of the provided performance information. The related federal contract opportunity is from the Department of the Interior Fish and Wildlife Service, with solicitation number 140FNR25Q0019, focused on AL Deep Horizon NRDA & Restoration Aerial Images.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140FNR25Q0019.pdf | ||
| PWS_NBIUASImagery_2025.docx | DOCX document | |
| WD_15-5189.txt | TXT text file |
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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__________________________________________
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