Attachment C - Past Performance Questionnaire Marietta NC.pdf
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- Solicitation number
- QSE--36C78625Q50200
About this file
The document is a Past Performance Questionnaire designed for contractors to provide details about their previous government and private sector contract work. The form requires contractors to list between three to five contracts completed within the last three years, with a specific instruction to prioritize National Cemetery Administration (NCA) contracts. The questionnaire captures comprehensive contract information including contractor details, contract specifics (number, type, dollar value, award date, status), point of contact information, and a description of services provided. Contractors must specify their role (prime or subcontractor), percentage of work completed, and provide context about the complexity and relevance of the work performed. The form is specifically associated with a grounds maintenance solicitation for the Marietta National Cemetery, issued by the Department of Veterans Affairs National Cemetery Administration, with solicitation number QSE--36C78625Q50200.
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PAST PERFORMANCE QUESTIONNAIRE
INSTRUCTIONS: Offerors must identify previous federal, state, local government, and or private contracts completed and that are similar in size and scope to the contract being evaluated. List at least three (3), but no more than five (5) contracts performed within the last three (3) years. (One contract reference per form; Form may be duplicated)
NOTE: List any National Cemetery Administration (NCA) contracts currently working or previously worked first followed by Non-NCA contracts.
Contractor (you) Information:
Name: ______________________________________________________________________________
Address: ____________________________________________________________________________
Telephone Number: ___________________________________________________________________
E-mail: ______________________________________________________________________________
Contract Information:
Name of company/agency you provided service for: __________________________________________
Contract Number: ____________________________________________________________________
Type of Contract: _____________________________________________________________________
Contract Dollar Value: _________________________________________________________________
Date of Award: _______________________________________________________________________
Status: Completed, yes____ No____ If not completed, projected completion date___________________
If not completed, why? _________________________________________________________________
Were you the Prime? ________ were you the Sub? _______
Point of Contact Information for the company/agency you serviced:
Name of the Contract Person & their position: _______________________________________________
Address: ____________________________________________________________________________
Telephone Number: ___________________________________________________________________
E-mail: _____________________________________________________________________________
Description of Supply/Service(s) provided, location & relevancy of work:
Complexity of Product/Service, if any:
Percentage of Work completed by your company/by subcontractor: (If less than 100%, please explain the tasks you performed.)
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