Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- ME-ME COASTAL NWR-BOAT MOTOR REPLACEMENT
- Solicitation number
- 140FS326Q0026
About this file
This is a Past Performance Survey template used to evaluate contractor experience and qualifications for federal contract opportunities. The form collects comprehensive information about a company's organizational background, including firm establishment date, leadership, and SAM.gov registration details, along with entity classification (partnership, separate entity, or division).
The survey requires detailed documentation of up to three completed or in-progress contracts or subcontracts, with preference for government contracts but allowance for commercial work if government experience is unavailable. For each contract, respondents must provide contracting agency or company name, point of contact, contract number, dollar amount, project title and location, scope of work, the firm's role (prime, joint venture, or subcontractor), subcontract details, performance timeline including scheduled and actual completion dates, percentage of work completed, termination status, and quality control and safety plan implementation. The form additionally requires documentation of any quality control or safety issues encountered and their resolutions. A certification section at the end requires the survey preparer's name, title, phone number, email address, and signature with date. This template is being used in conjunction with solicitation 140FS326Q0026 for the ME-ME Coastal National Wildlife Refuge Boat Motor Replacement project issued by the Department of the Interior Fish and Wildlife Service.
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Other files
| File | Type | Posted |
|---|---|---|
| Sol_140FS326Q0026.pdf | ||
| B08_-_Specs.pdf | ||
| B08_-_SOW.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 .