S02 - Attachment 09 - Past Performance Survey (3 pages).docx
DOCX document 24 KB Posted
- Attached to
- J045--Replace Plumbing Systems in Bldg. 64 Federal contract opportunity
- Solicitation number
- 36C24822R0194
About this file
This document contains a past performance survey template and details of a federal solicitation for plumbing replacement services. The past performance survey template collects information on up to five previous projects, including contractor details, contract numbers, work descriptions, performance periods, completion statuses, percentages subcontracted, difficulties encountered, and pricing details. The solicitation seeks proposals to remove and replace overhead sanitary piping in a building basement at the Lake City Veterans Affairs Medical Center in Florida, with work to be done according to provided specifications and drawings. A mandatory site visit is scheduled for October 18th, 2022 at 10:00AM EST for interested offerors to meet at the specified campus address. The Department of Veterans Affairs Veterans Health Administration VISN 8 is the contracting agency.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C24822R0194 0001.docx | DOCX document | |
| S02 - Attachment 07 - Experience Modification Rate (EMR) (1 page).docx | DOCX document | |
| S02 - Attachment 11 - Subcontractor Past Performance Consent Form (1 page).docx | DOCX document | |
| S02 - Attachment 10 - Letter of Commitment Key Subcontractors (1 page).pdf | ||
| S02 - Attachment 03 - VAAR 852.219-77 LOS Certification (2 pages).docx | DOCX document | |
| S02 - Attachment 01 - Drawings Replace Plumbing (68 pages).pdf | ||
| 36C24822R0194 (Replace Plumbing).docx | DOCX document | |
| S02 - Attachment 08 - Past Performance Questionnaire (3 pages).docx | DOCX document | |
| S02 - Attachment 06 - Price Matrix (1 page).xlsx | XLSX spreadsheet | |
| S02 - Attachment 05 Wage Determination.pdf | ||
| S02 - Attachment 04 - VHA Supplemental Contract Requirements for Combatting COVID-19 (2 pages).docx | DOCX document | |
| S02 - Attachment 02 - Specifications Replace Plumbing (360 pages).pdf |
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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 .