Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- DE - Prime Hook NWR - JANITORIAL SERVIICES Federal contract opportunity
- Solicitation number
- 140FS325Q0117
About this file
The document is a Past Performance Survey form designed to collect detailed information about a company's previous contract work. The survey requires businesses to provide comprehensive details about up to three contracts, including contracting agency, contract number, project scope, contract amount, performance period, role (prime, joint venture, or subcontractor), and quality control/safety plan implementation.
The form captures critical past performance data such as contract completion status, percentage of work completed, subcontractor details, and any quality control or safety problems encountered. The survey is associated with a Department of the Interior Fish and Wildlife Service solicitation (140FS325Q0117) for janitorial services at Prime Hook National Wildlife Refuge, and requires the completing company to certify the accuracy of the information through a signed statement by an authorized representative.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140FS325Q0117.pdf | ||
| B08_-_SOW-PMH_Cleaning_Contract_2025_DRAFT_(1).pdf | ||
| B03_-_Service_Contract_Act_WD_2015-5863.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 .