Past_Performance_Survey.pdf
PDF 127 KB Posted
- Attached to
- HVAC Replacement - WV Federal contract opportunity
- Solicitation number
- 140FC226R0011
About this file
This is a Past or Present Performance Survey form used to collect historical contract performance information from companies bidding on federal contracts.
The form requires companies to provide general business information including company name, address, date established, company officers, Dun & Bradstreet number, and business structure. Companies must then complete detailed information on up to three prime contracts or subcontracts, whether government or commercial. For each contract, respondents must identify the contracting agency or company, point of contact, contract number, contract amount, project title and location, general scope of work, and the company's role (prime contractor, joint venture member, or subcontractor). Additional required details include the amount and description of any subcontracted work, period of performance in days, scheduled and actual completion dates, percentage of work completed, termination status, quality control and safety plan usage, any quality control or safety problems encountered, and how those problems were resolved. The form concludes with a certification section requiring the survey preparer's name, phone number, email, title, signature, and date. This survey serves as a standard evaluation tool to assess a company's capability and track record before contract award.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Sol_140FC226R0011_Amd_0002.pdf | ||
| B09_Amd2_Q_A_HVAC_WV_0002.docx | DOCX document | |
| Sol_140FC226R0011_Amd_0001.pdf | ||
| SOW_HVAC_Replacement_with_drawings.pdf | ||
| Sol_140FC226R0011.pdf | ||
| Wages.pdf | ||
| B08_Bid_Sheet.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:
Dun & Bradstreet Number: __
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:
Point of Contact: Telephone Number:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: %
c. Third Contract:
Point of Contact: Telephone Number:
Your Role (Prime [ ], Joint Venture [ ], or Subcontractor [ ]) and the work your firm performed:
Scheduled Completion Date:
Actual Completion Date: Percentage of Work Completed: %
4. Certification of Past Performance Information:
Type or Print Information
Name of Survey Preparer _______________________________Phone:_________________
E-Mail;___________________________
Title__________________________________________
Signature______________________________________
Date__________________________________________
| PAST OR PRESENT PERFORMANCE SURVEY |
| 1. GENERAL BUSINESS INFORMATION |
| 2. CONTRACTS/SUBCONTRACTS COMPLETED OR IN PROGRESS |
File details come from the government source that posted it. Updated .