Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- VA-DIOMA PERNAMBUCCO FEASIBLILITY STUDY
- Solicitation number
- 140FS326Q0103
About this file
This is a Past Performance Survey document designed to evaluate contractor performance on the VA-DIOMA Pernambucco Feasibility Study solicitation (140FS326Q0103) issued by the Department of the Interior Fish and Wildlife Service. The survey serves as an assessment tool for gathering information about a contractor's prior performance history, capability, and reliability in delivering similar projects. The document functions as a template or evaluation instrument rather than specifying contract requirements, deliverables, or pricing terms.
The survey is intended to support the government's evaluation process by collecting structured feedback on contractor performance metrics, past project completion, quality of work, adherence to schedules and budgets, and overall capability to execute the proposed feasibility study. As a Past Performance Survey template, it does not contain specific response dates, award dates, pricing information, set-asides, or federal contract vehicle designations, but rather establishes the framework through which past performance will be assessed during the procurement evaluation phase for this Department of the Interior initiative.
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Other files
| File | Type | Posted |
|---|---|---|
| B08_-_Pernambuco_Traceability_Feasibility_Study_SOW_6-12-26.pdf | ||
| Sol_140FS326Q0103.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:
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): $
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: % Were You Terminated?
Quality Control or Safety Problems encountered (if any):
How were the problems resolved? _____
c. Third 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): $
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: % Were You Terminated?
Quality Control or Safety Problems encountered (if any):
How were the problems resolved? _____
Type or Print Information Name of Survey Preparer
Phone:_________________ E-Mail;___________________________ Title Signature Date )4. Certification of Past Performance Information:
File details come from the government source that posted it. Updated .