S02 - Attachment 09 - Past Performance Survey (3 pages).docx
DOCX document 24 KB Posted
- Attached to
- Z2DA--Correct Tunnel Water Protection Federal contract opportunity
- Solicitation number
- 36C24822R0156
About this file
This document contains a past performance survey template for federal contractors to submit references from prior similar contracts. The three page survey requests information on up to five past performance projects, including the contractor's role, scope of work performed, difficulties encountered and resolutions, performance periods from start to completion dates, and original and final contract prices. Relevant details to summarize the contractor's experience and past performance are also solicited, such as explanations of project selection and relevancy to the current solicitation. Termination information for any prior contracts is additionally requested.
The related federal contract opportunity is a solicitation for correct tunnel water protection construction services at the Gainesville VA Medical Center in Florida. A pre-bid site visit is scheduled for August 15, 2022 at 10:00 am where participants should meet at the specified basement entrance and engineering office conference room. The contracting agency is the Department of Veterans Affairs Veterans Health Administration VISN 8.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| S02 - Attachment 07 - Experience Modification Rate (EMR) (1 page).docx | DOCX document | |
| S02 - Attachment 02 - Specifications (462 pages).docx | DOCX document | |
| S02 - Attachment 10 - Letter of Commitment Key Subcontractors (1 page).pdf | ||
| S02 - Attachment 08 - Past Performance Questionnaire (3 pages).docx | DOCX document | |
| S02 - Attachment 06 - Price Matrix (1 page).xlsx | XLSX spreadsheet | |
| S02 - Attachment 01 - Drawings (26 pages).pdf | ||
| S02 - Attachment 11 - Subcontractor Past Performance Consent Form (1 page).docx | DOCX document | |
| S02 - Attachment 05 - Wage Determination (5 pages).pdf | ||
| S02 - Attachment 04 - VHA Supplemental Contract Requirements for Combatting COVID-19 (2 pages).docx | DOCX document | |
| S02 - Attachment 03 - LOS Certification (1 page).docx | DOCX document | |
| 36C24822R0156 (BB Correct Tunnel).docx | DOCX document |
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Text version
PAST PERFORMANCE SURVEY SHEET
PROJECT NO. [ ] Page 1 A minimum of three (3) and a maximum of five (5) past performance projects.
a. Contractor Information of awarded contract (Firm Name, Address, Unique Entity Identifier ID, and Cage Code, Phone number (include area code), POC Name, POC email, Company email)
b. Contract and/or Task Order Number and Award Date (mm/dd/yyyy)
c. Project Title/Name and Location
d. Work Performed as: Prime Contractor, Subcontractor, Joint Venture, Other (explain):
e. Percent (%) of project work performed by your company
f. If you work as subcontractor, who was the prime?
(Firm Name, Address, Unique Entity Identifier ID, and Cage Code, Phone number, POC Name, POC email, Company email)
g. Government Agency/Company which awarded contract to offeror, and Contact Information, such Contracting Officer/Procurement Official/COR/Point of Contact/ (Name, Title, Email, Phone Number).
PAST PERFORMANCE SURVEY
| PAST PERFORMANCE SURVEY SHEET | |
| PROJECT NO. [ | ] Page 2 |
h. Description of project’s scope of work and the offeror’s specific roles and responsibilities in the project: Describe work performed in sufficient detail to permit evaluation of project relevancy to this procurement. Detail how work performed is relevant to the effort required by the solicitation? Use continuation sheet for additional information, if necessary.
| PAST PERFORMANCE SURVEY SHEET | |
| PROJECT NO. [ | ] Page 3 |
i. Explanation of why the projects were selected as the same or similar and how the experience obtained on the submitted project is pertinent to the execution of this project.
j. Describe any difficulties and/or obstacles encountered during performance; steps taken toward resolution. Describe unforeseen conditions and how each were resolved
k. Performance Period, including contract start date (mm/dd/yyyy), and original completion date (mm/dd/yyyy), if not completed, projected date (mm/dd/yyyy)
| Contract Start Date: |
| Original Completion Date, if not completed, projected completion date (mm/dd/yyyy) |
l. Actual Completion Date (mm/dd/yyyy), and if not completed, why?
Actual Completion Date:
If not completed, Why?
m. Project is 50% or more complete? YES [ ] No [ ]. If “No” explain percentage of completion, if not 50% completed for any reason, rating may be lower.
n. The Offerors shall indicate if any of the contracts listed were terminated and the type and reasons for the termination.
o. Original Contract Price (Award Amount), Final Contract Price (to include all modifications, if applicable), Explain Differences.
Original Contract Price: Final Contract Price:
Explain Differences:
File details come from the government source that posted it. Updated .