Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- VT-MISSISQUOI NWR-INVASIVE TREATMENT
- Solicitation number
- 140FS326Q0112
About this file
This is a Past Performance Survey template designed to collect historical contract performance information from prospective federal contractors. The form requests general business information including company name, address, SAM.gov Unique Entity Identifier (UEI), organizational structure, and key personnel (President and Vice President). The survey requires detailed documentation of up to three completed or in-progress contracts or subcontracts, whether government or commercial in nature.
For each contract entry, the survey collects comprehensive performance data including the contracting agency or company name, point of contact information, contract number, total contract amount, project title and location, scope of work, the contractor's role (prime, joint venture, or subcontractor), subcontracted amounts, performance timeline with scheduled and actual completion dates, and percentage of work completed. Additionally, the form requests information on contract terminations, quality control plans, safety plans, any quality control or safety issues encountered, and how those issues were resolved. The survey concludes with certification requirements and must be signed by the survey preparer with contact information and date. This template serves as an evaluation tool for federal agencies to assess contractor capability and reliability based on past contract performance history.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FS326Q0112.pdf | ||
| B03_-_Service_Contract_Act_WD_2015-6143.pdf | ||
| B08_-_Maps.pdf | ||
| B03_-_Service_Contract_Act_WD_2015-4137.pdf | ||
| B08_-_SOW.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .