Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- TN-WEST TENNESSEE REFUGE-FOLDING DISK
- Solicitation number
- 140FS326Q0147
About this file
This is a Past Performance Survey template designed to collect historical contract performance information from companies bidding on federal opportunities. The survey gathers general business information including company organization date, key personnel, and SAM.gov Unique Entity Identifier, followed by detailed documentation of up to three completed or in-progress contracts or subcontracts.
For each contract entry, the survey requires comprehensive performance data including the contracting agency or company name, point of contact, contract number, dollar amount, project title and location, scope of work, the responding company's role (prime, joint venture, or subcontractor), subcontract details, period of performance, scheduled and actual completion dates, and percentage of work completed. Additional required information includes termination status, implementation of quality control and safety plans, identification of any quality control or safety problems encountered, and documentation of how problems were resolved. The template concludes with fields for the survey preparer's name, phone, email, title, signature, and date, along with a certification statement for the accuracy of past performance information provided. This template is associated with solicitation 140FS326Q0147 for TN-West Tennessee Refuge-Folding Disk issued by the Department of the Interior Fish and Wildlife Service.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FS326Q0147.pdf | ||
| B08_-_Disk_spec_sheet.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 .