Past_Performance_Survey.docx
DOCX document 24 KB Posted
- Attached to
- MS-NOXUBEE NWR-CRUSH-IN-RUN LIMESTONE Federal contract opportunity
- Solicitation number
- 140FS326Q0100
About this file
This is a Past Performance Survey template used to collect information about a contractor's previous contract experience. The survey requests general business information including company name, address, organization date, key personnel, and SAM.gov Unique Entity Identifier (UEI), as well as the contractor's business structure (partnership, separate entity, or division).
The form requires detailed documentation of up to three completed or in-progress contracts or subcontracts, with preference for government contracts but allowing commercial contracts if government experience is unavailable. For each contract, respondents must provide the contracting agency or company name, point of contact, telephone number, contract number, contract amount, project title and location, scope of work, the contractor's role (prime, joint venture, or subcontractor), subcontracted work details, period of performance, scheduled and actual completion dates, and percentage of work completed. The survey also requires disclosure of any contract terminations, implementation of quality control and safety plans, any quality control or safety problems encountered, and how those problems were resolved. The completed survey must be signed and dated by the survey preparer with their contact information included.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140FS326Q0100.pdf | ||
| Section_Line_Road_Map.jpg | JPG image | |
| Statement_of_Work_section_line_road_docx.docx | DOCX document |
On GovTribe
Work with this file on GovTribe
- 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 .