Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- FIRE BIL - HERBICIDE TREATMENT AL Key Cave NWR
- Solicitation number
- 140FS326Q0078
About this file
This is a Past Performance Survey template designed to collect historical contract performance information from vendors seeking federal contract opportunities. The survey requires companies to provide general business information including company name, address, establishment date, key personnel, and SAM.gov Unique Entity Identifier (UEI), along with organizational structure details such as whether the firm is a partnership, separate entity, or division.
The survey requests detailed information on up to three completed or in-progress contracts or subcontracts, whether government or commercial in nature. For each contract, respondents must document the contracting agency or company name, point of contact information, contract number, contract amount, project title and location, scope of work, the company's role as prime contractor, joint venture partner, or subcontractor, subcontract details, period of performance, scheduled and actual completion dates, percentage of work completed, termination status, quality control and safety plan implementation, and any quality control or safety issues encountered and their resolutions. The template includes signature and certification blocks for the survey preparer, requiring name, title, phone, email, and date. This document serves as a standard assessment tool for evaluating contractor qualifications and past performance capabilities relevant to the Fish and Wildlife Service's herbicide treatment solicitation for Key Cave National Wildlife Refuge (Solicitation Number 140FS326Q0078).
View the file
Other files
| File | Type | Posted |
|---|---|---|
| B08_-_PWS_-_Key_Cave_NWR_Herbicide_Treatment.pdf | ||
| B03_-_Service_Contract_Act_WD_2015-4599.pdf | ||
| Sol_140FS326Q0078.pdf | ||
| Quote_Schedule_2026_Herbicide_M_D_rev1.docx | DOCX document |
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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 .