Attachment C - Past Performance Questionnaire.pdf

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Attached to
Water Treatment System -- H946
Solicitation number
QSE--36C78624Q50184
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About this file

This document is a Past Performance Questionnaire, which is used to provide information about previous federal, state, local government, or private contracts completed that are similar in size and scope to the contract being evaluated. It requires the contractor to list at least three (3) contracts for evaluation, which must be either competed or current within the last five (5) years. One contract reference per form is required. The contractor must provide details such as the contract number, contractor information, type of contract, contract dollar value, date of award, type and extent of subcontracting, percentage of work completed, description of the supplies/services provided, location and relevancy of the work, and contact information for the contract reference.

The related federal contract opportunity is for a Water Treatment System Operation, Maintenance, and Documentation, Bacteriological Testing, and Nitrate and Nitrite Testing at the Jacksonville National Cemetery, which is a set-aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSBs). The Department of Veterans Affairs, National Cemetery Administration (NCA) intends to release a commercial solicitation for these services. A site visit is scheduled for July 15, 2024, from 10:00 am to 12:00 pm Eastern, and will not be rescheduled.

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PAST PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS: Contractor must identify previous federal, state, local government and or private contracts completed that are similar in size and scope to the contract being evaluated. List at least three (3) contracts for evaluation. Contracts must be either competed or current within the last (5) years. One contract reference per form.

Note: List any National Cemetery Administration (NCA) contracts currently working or previously worked first followed by Non-NCA contracts.

Past Performance Questionnaire

Contract Number Contractor (Name Address, Zip Code)

Telephone Number Email Address Type of Contract Contract Dollar Value Date of Award (if not completed provide status)

Type/Extent of Subcontracting

Percentage of Work completed by the Contractor

Description of Supply/Services provided, location & relevancy of work

Address, Telephone Number & Email of the Contact Person, and Position

Form may be duplicated.

File details come from the government source that posted it. Updated .