Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- AR-FELSENTHAL NWR-GRAVEL_FY26
- Solicitation number
- 140FS326Q0091
About this file
This is a Past Performance Survey template designed to collect historical contract performance information from contractors bidding on federal opportunities. The survey requests general business information including company name, address, organization date, key personnel, and SAM.gov Unique Entity Identifier, along with partnership or entity structure classification. The form requires contractors to document up to three completed or in-progress contracts or subcontracts, whether from government agencies or commercial entities, with detailed information for each including the contracting entity, point of contact, contract number, contract amount, project title and location, scope of work, the contractor's role (prime, joint venture, or subcontractor), subcontracting details, period of performance, scheduled and actual completion dates, and work completion percentage.
For each contract listed, the survey also requests information on termination status, quality control and safety plan implementation, any quality control or safety problems encountered during performance, and how such problems were resolved. The form must be completed and signed by the survey preparer, including their name, phone number, email, title, and date, followed by certification of the past performance information provided. This template is not tied to specific deliverables or services for the AR-Felsenthal NWR Gravel FY26 solicitation but serves as a standard evaluation tool for assessing contractor capability and reliability based on historical performance.
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Other files
| File | Type | Posted |
|---|---|---|
| B08_-_Specs_and_Delivery_Coordinates.pdf | ||
| Sol_140FS326Q0091.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 .