Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- DE-PRIME HOOK NWR-PRIME HOOK DUMPSTER Federal contract opportunity
- Solicitation number
- 140FS325Q0052
About this file
The document is a Past Performance Survey form designed to collect detailed information about a company's previous contracts and project experiences. The form requires comprehensive documentation for up to three contracts, including contract details such as contracting agency, point of contact, contract number, contract amount, project title, role (prime, joint venture, or subcontractor), scope of work, subcontractor information, performance period, completion status, and quality/safety plan implementation.
The survey is associated with a specific federal contract opportunity (Solicitation Number: 140FS325Q0052) for the Department of the Interior Fish and Wildlife Service, involving work at Prime Hook National Wildlife Refuge related to dumpster services. The form seeks to provide potential bidders an opportunity to demonstrate their past performance capabilities by detailing prior contract experiences, including project specifics, challenges encountered, and resolution strategies. The document includes sections for general business information, contract details, and a certification of past performance information, with space for the survey preparer to provide contact and signature details.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140FS325Q0052.pdf | ||
| B08_-_Estimated_Waste_Total.pdf | ||
| B03_-_Service_Contract_Act_WD___2015-4271.pdf | ||
| B08_-_SOW.pdf | ||
| B08_-_Quote_Schedule.pdf |
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Text version
PAST OR PRESENT PERFORMANCE SURVEY
Your Company Name:
Street Address:
City, State and ZIP Code:
1. GENERAL BUSINESS INFORMATION
Date Firm Organized/Established:
Company President:
Vice President:
SAM.gov Unique Entity Identifier (UEI):
Is company a ; Partnership [ ] Separate entity [ ] Division [ ] N/A [ ]
2. CONTRACTS/SUBCONTRACTS COMPLETED OR IN PROGRESS
Complete and submit the information requested on page 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 Title and 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: days Scheduled Completion Date:
Actual Completion Date:
Percentage of Work Completed:
Were You Terminated?
Did you use a Quality Control Plan? _________ Did you use a Safety Plan?_______________
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 Performance Information:
Type or Print Information
Name of Survey Preparer _______________________________Phone:_________________
E-Mail;___________________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
File details come from the government source that posted it. Updated .