Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- Well Redevelopment Services - VT Federal contract opportunity
- Solicitation number
- 140FC225R0011
About this file
The document is a Past Performance Survey form designed to collect detailed information about a company's contract history and performance. The survey requires comprehensive details about up to three contracts, including contracting agency, contract number, project scope, performance role, contract amount, period of performance, completion status, and quality control/safety plan implementation.
The survey captures critical business and contract information such as company organization date, leadership, entity type, and SAM.gov Unique Entity ID. For each contract, respondents must provide granular details including contract type (prime, joint venture, subcontractor), percentage of work completed, termination status, quality control and safety plan usage, and any problems encountered during contract execution. The form concludes with a certification section requiring the survey preparer's signature, contact information, and date of completion. The related federal contract opportunity is for Well Redevelopment Services in Vermont, issued by the Department of the Interior Fish and Wildlife Service under solicitation number 140FC225R0011.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| B08_Tech_Specs_Well_1_3.pdf | ||
| Sol_140FC225R0011.pdf | ||
| B08_Wages.pdf | ||
| B08_Bid_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 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__________________________________________
File details come from the government source that posted it. Updated .