Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- MS-FWS NOXUBEE-HERBICIDE Federal contract opportunity
- Solicitation number
- 140FS325Q0063
About this file
The document is a Past Performance Survey form designed to collect detailed historical contract information from potential contractors. The survey requests comprehensive details about three previous contracts, including contracting agency, contract value, project scope, performance role (prime, joint venture, or subcontractor), subcontracted work, performance dates, completion percentage, quality control and safety plan usage, and any contract terminations or problems encountered.
The survey is associated with a specific federal contract opportunity (Solicitation Number: 140FS325Q0063) from the Department of the Interior Fish and Wildlife Service, titled "MS-FWS NOXUBEE-HERBICIDE". The form requires companies to provide their general business information, SAM.gov Unique Entity Identifier, organizational structure, and a certification of past performance information, signed by an authorized representative. This survey is likely part of a procurement process to evaluate a contractor's experience and capability for the herbicide-related project.
View the file
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| File | Type | Posted |
|---|---|---|
| B08_-_SOW_Bicolor_Spraying_SDHNoxubee_NWR_2025_(1).pdf | ||
| Sol_140FS325Q0063.pdf | ||
| B03_-_Service_Contract_Act_WD___2015-5157.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 .