Past_Performance_Survey.doc
DOC document 35 KB Posted
- Attached to
- FL PELICAN ISLAND NWR BLACK RAIL SURVEYS
- Solicitation number
- 140FS325Q0153
About this file
The document is a Past Performance Survey form designed to collect detailed information about a company's previous contract work. The multi-page template requires businesses to provide comprehensive details about up to three contracts, including contract value, performance period, role (prime/subcontractor), project scope, contact information, and performance metrics such as quality control and safety plans.
The survey captures critical past performance data through sections requesting general business information, contract/subcontract details, and a certification of performance information. Companies are asked to document contracting agency, project location, contract amount, performance dates, work percentage completed, termination status, and any quality control or safety issues encountered. The form appears to be a standard tool for evaluating a company's previous contract execution capabilities, likely used in the federal procurement process to assess contractor reliability and performance history.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| B03_-_Service_Contract_Act_WD_2015-4541_-_Polk_County_FL.pdf | ||
| Sol_140FS325Q0153.pdf | ||
| B08_-_PWS___QASP.pdf | ||
| B08_-_Location_Maps.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__________________________________________
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