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This is a Past Performance Questionnaire template required for contractors bidding on federal contract opportunities. Contractors must submit at least three (3) references of similar contracts completed within the last five years, listing either competed or current contracts. National Cemetery Administration (NCA) contracts should be listed first, followed by non-NCA contracts. Each reference requires completion of a separate form documenting the contract number, contractor information (name, address, zip code, telephone, email), contract type, dollar value, award date or completion status, subcontracting details, percentage of work completed by the contractor, and a description of supplies/services provided with work location and relevancy. Contact information for a reference person at the performing organization must also be provided.

For this specific opportunity, contractors bidding on Solicitation QSE--36C78626Q50035 for Trash Removal Services at the Long Island National Cemetery must provide past performance references demonstrating experience with similar waste management or facility maintenance contracts. The contract is issued by the Department of Veterans Affairs National Cemetery Administration for a base year plus four option years, with an estimated performance period of April 1, 2026 through March 31, 2027, under Wage Determination 2015-4157. Applicants should prioritize including any previous NCA or Department of Veterans Affairs contracts in their past performance submissions to demonstrate relevant experience with federal cemetery or veterans facility operations.

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PAST PERFORMANCE QUESTIONAIRE

INSTRUCTIONS: Contractor must identify previous federal, state, local government and or private contracts completed that are similar in size and scope to the contract being evaluated. List at least three (3) contracts for evaluation. Contracts must be either competed or current within the last (5) years. One contract reference per form.

Note: List any National Cemetery Administration (NCA) contracts currently working or previously worked first followed by Non-NCA contracts.

Past Performance Questionnaire

Contract Number

Contractor ( Name Address, Zip Code)

Telephone Number

Email Address

Type of Contract

Contract Dollar Value

Date of Award (if not completed provide status)

Type/Extent of Subcontracting

Percentage of Work completed by the Contractor

Description of Supply/Services provided, location & relevancy of work

Address, Telephone Number & Email of the Contact Person and Position

Form may be duplicated

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