Solicitation Attachment XV - Past Performance Survey.pdf
PDF 147 KB Posted
- Solicitation number
- FA441826R0009
About this file
This is a Past Performance Survey form used to document and evaluate a contractor's relevant experience on present or past contracts.
The form requires contractors to provide comprehensive information for each contract identified, including: prime contractor company name with CAGE Code and Unique Entity ID; the contractor's role (Prime, Sub, JV Partner, Teaming Partner, Predecessor Company, Consultant, or Key Personnel); project title; complete customer name and contact information; contract number; contract type (Design-Build or Design-Bid Build); preponderance of work category (Existing Whole Building Renovation, Utility Infrastructure Repair/Construction, or Other); period of performance in calendar days; place of performance; initial contract price and final amount invoiced; original and current scheduled completion dates; and final completion date or estimated percent completion. The form also requires a detailed description of work performed and an explanation of relevance to the effort, specifically addressing how the contract's scope, magnitude, and complexity relate to individual task orders contemplated under the solicitation. Additionally, contractors must provide contact information for two references: the Project Manager/Technical Representative and the Contracting Officer/Procurement Manager, including their respective names, offices, addresses, telephone numbers, and email addresses. A separate completed form must be submitted for each contract cited as past performance.
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Past Performance Survey
PAST PERFORMANCE SURVEY
Past Performance Project List Reference No. (#1-#N)
Provide the information requested in this form for each one of the present or past contracts you have identified. Provide a separate completed form for each contract identified.
A. Prime Contractor on Project (Company/Division):
CAGE Code:
Unique Entity ID:
Role of Offeror in Effort (Prime Contractor, Sub Contractor, JV Partner, Teaming Partner, Predecessor Company, Consultant, Key Personnel):
B. Project Title:
C. Contract Specifics:
1. Complete Name of Customer:
2. Customer Address and Telephone #:
3. Contract Number or Citation:
4. Type of Contract (Design-Build or Design- Bid Build):
5. Preponderance of Work (Existing Whole Building Renovation, Utility Infrastructure Repair/Construction, or Other):
6. Period of Performance (Calendar Days):
7. Place of Performance (City, State):
8. Initial Contract Price: $
9. Final Amount Invoiced/Invoiced to Date: $
10. Original Contract Completion Date:
11. Current Sched Contract Completion Date:
12. If complete, Final Completion Date:
OR Estimated Percent Completion:
D. Description of Work:
E. Relevance: Describe how the work under this contract relates to the relevancy (scope, magnitude, and complexity) to the effort of individual task orders contemplated to be issued on this contract.
1. Project Manager and/or Technical Representative
2. Contracting Officer and/or Procurement Manager
Name:
Office:
Address:
Telephone:
E-Mail:
| Provide the information requested in this form for each one of the present or past contracts you have identified Provide a separate completed form for each contract identified: |
| A Prime Contractor on Project CompanyDivision: |
| CAGE Code: |
| Unique Entity ID: |
| Role of Offeror in Effort Prime Contractor Sub Contractor JV Partner Teaming Partner Predecessor Company Consultant Key Personnel: |
| B Project Title: |
| C Contract Specifics: |
| 1 Complete Name of Customer: |
| 2 Customer Address and Telephone: |
| 3 Contract Number or Citation: |
| 4 Type of Contract DesignBuild or Design Bid Build: |
| 5 Preponderance of Work Existing Whole Building Renovation Utility Infrastructure RepairConstruction or Other: |
| 6 Period of Performance Calendar Days: |
| 7 Place of Performance City State: |
| 10 Original Contract Completion Date: |
| 11 Current Sched Contract Completion Date: |
| 12 If complete Final Completion Date: |
| OR Estimated Percent Completion: |
| D Description of WorkRow1: |
| E Relevance Describe how the work under this contract relates to the relevancy scope magnitude and complexity to the effort of individual task orders contemplated to be issued on this contractRow1: |
| 1 Project Manager andor Technical RepresentativeName: |
| 2 Contracting Officer andor Procurement ManagerName: |
| 1 Project Manager andor Technical RepresentativeOffice: |
| 2 Contracting Officer andor Procurement ManagerOffice: |
| 1 Project Manager andor Technical RepresentativeAddress: |
| 2 Contracting Officer andor Procurement ManagerAddress: |
| 1 Project Manager andor Technical RepresentativeTelephone: |
| 2 Contracting Officer andor Procurement ManagerTelephone: |
| 1 Project Manager andor Technical RepresentativeEMail: |
| 2 Contracting Officer andor Procurement ManagerEMail: |
| #1 - #N: |
| $: |
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