Past_Performance_Survey.pdf
PDF 155 KB Posted
- Attached to
- AL-WHEELER NWR-MULCHING TEN ACRES
- Solicitation number
- 140FS326Q0143
About this file
This is a Past or Present Performance Survey form designed to collect historical contract performance information from bidders or contractors responding to a federal contract opportunity.
The survey requires companies to provide general business information including company name, address, date established, UEI number from SAM.GOV, company leadership names, and small business status. The primary focus is documenting up to three completed or in-progress contracts or subcontracts, whether from government agencies or private companies. For each contract entry, respondents must supply the contracting entity and point of contact information, contract number and amount, project title and location, scope of work, the company's role (prime, joint venture, or subcontractor), description of any subcontracted work with associated amounts, period of performance in days, scheduled and actual completion dates, percentage of work completed, termination status, and whether quality control and safety plans were implemented. The form also requires documentation of any quality control or safety problems encountered and their resolution methods. The survey concludes with a certification section requiring the preparer's name, phone, email, title, signature, and date. This is a template form with no specific response deadline, award date, pricing terms, or federal agencies identified, as it serves as a standardized attachment for evaluating contractor past performance across multiple solicitations.
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| A04_Wheeler_NWR_Mulching_FY26_SOW.pdf | ||
| B03_Wage_Determination.pdf | ||
| Sol_140FS326Q0143.pdf |
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Text version
ATTACHMENT 3 page 1 of 5
PAST OR PRESENT PERFORMANCE SURVEY
Your Company Name:
Street Address:
City, State/Territory and ZIP Code:
1. GENERAL BUSINESS INFORMATION
Date Firm Organized/Established:
Company President: Vice President:
WWW.SAM.GOV UEI Number:_______________ __
Is company a small business? YES [ ] NO [ ] 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.
http://www.sam.gov/
ATTACHMENT 3 page 2 of 5
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?
ATTACHMENT 3 page 3 of 5
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: %
ATTACHMENT 3 page 4 of 5
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: %
ATTACHMENT 3 page 5 of 5
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 |
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