Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- HVAC and Remediation Services - LA
- Solicitation number
- 140FC225R0008
About this file
The document is a Past Performance Survey form designed to collect detailed information about a company's contract history. The survey requests comprehensive data about up to three contracts, including general business information, contract details, performance metrics, and company structure. Key sections require companies to provide information such as contracting agency, contract number, contract amount, project scope, role (prime, joint venture, or subcontractor), period of performance, completion status, subcontracting details, and quality control/safety plan implementation.
The survey form is associated with a Department of the Interior Fish and Wildlife Service solicitation (Number: 140FC225R0008) for HVAC and Remediation Services in Louisiana. The form is intended to help the agency evaluate a potential contractor's past performance by gathering evidence of previous contract execution, project management capabilities, quality control processes, and overall performance history. The detailed nature of the survey suggests that past performance will be a significant factor in contractor selection for this HVAC and remediation services opportunity.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FC225R0008_Amd_0001.pdf | ||
| Wages.pdf | ||
| B08_SOW.pdf | ||
| Sol_140FC225R0008.pdf | ||
| B08_Bid_Shedule.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 ID:
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__________________________________________
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