PastPerformanceQuestionnaire.docx
DOCX document 16 KB Posted
- Solicitation number
- W912PL-16-R-0018
About this file
Amendment 1. The Past Performance Questionnaire form is provided as a WORD document.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
USACE PAST PERFORMANCE QUESTIONNAIRE
CONTRACT INFORMATION (Contractor to Complete Blocks 1-4)
1. Contractor Information
Firm Name:
| Cage Code: |
| DUNS Number: |
Address:
| Email: |
| Phone Number: |
| Point of Contact |
| POC Phone Number: |
2. Work Performed as:
Prime Contractor
Subcontractor
Joint Venture
Other (Explain)
% Work Performed:
If subcontractor, who was prime? (Name/Phone):
3. Contract Information Contract Number:
Delivery/Task Order Number (if applicable):
Contract Type:
Firm Fixed Price
Cost Reimbursement
Other (Specify)
Contract Title:
Contract Location:
Award Date (mm/dd/yy):
Contract Completion Date (mm/dd/yy): Actual Completion Date (mm/dd/yy) Explain Differences:
Original Contract Price (Award Amount):
Final Contract Price (to include all modification, if applicable): Explain Differences:
4. Project Description:
Complexity of Work:
High
Medium
Routine
How is this project relevant to project of submission? (Please provide details such as similar equipment, requirements, conditions, etc.)
CLIENT INFORMATION (Client to complete Blocks 5-8)
5. Client Information Name: Title:
Phone Number: Email Address:
6. Describe the client's role in the project:
7. Date Questionnaire was completed (mm/dd/yy):
8. Clients Signature:
File details come from the government source that posted it. Updated .