Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- TN-TN NWR-WCS MATERIALS Federal contract opportunity
- Solicitation number
- 140FS326Q0101
About this file
This is a Past Performance Survey template used to collect historical contract performance information from vendors bidding on federal opportunities. The document requests comprehensive details about a company's completed or in-progress contracts, whether with the government or private entities, with preference given to government contract experience. Respondents must provide general business information including company establishment date, organizational structure, SAM.gov Unique Entity Identifier, and key personnel.
The survey captures detailed contract information across multiple contract examples, including contracting agency or company name, contract number, dollar amount, project scope and location, the respondent's role (prime contractor, joint venture partner, or subcontractor), subcontracting details, performance period, scheduled and actual completion dates, and percentage of work completed. Additionally, the template collects information on contract terminations, quality control and safety plans implementation, and any quality control or safety issues encountered with descriptions of resolutions. The survey requires certification by the survey preparer with signature, title, phone, email, and date. This template is referenced in the Department of the Interior Fish and Wildlife Service solicitation TN-TN NWR-WCS MATERIALS (Solicitation Number 140FS326Q0101) as a mechanism for evaluating vendor past performance capability.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| WCS_Statement_of_Work_2026.pdf | ||
| Sol_140FS326Q0101.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 .