Appendix_L_06 Team Structure Format_20261104.docx

Appendix L-06 Team Structure Format

36C10F27R0003

Design-Build and Construction MATOC

Instructions: Complete one Appendix L‑06 for each team member (Prime, JV Partner, Subcontractor with signed TA, Mentor, or Protégé). Identify the team member’s business information, relationship to the Prime, all States/VA Medical Centers where the team member will perform, and the construction program areas they will support. All information must match the signed Teaming Agreements submitted in Volume II.

1. Prime or Team Member Information Name of Firm: _________________________________________________ Address:______________________________________________________ Phone: ______________________________________________________ Fax:_________________________________________________________ E-mail:_______________________________________________________ Unique Entity ID (UEI):_______________________ CAGE code: __________________________________________________

2. Prime/Team Member Relationship (Required per Section L‑2.5.5(2))

Describe the relationship between the Prime and this team member:

· Prime

· Joint Venture Partner

· Subcontractor (with signed Teaming Agreement)

· Mentor

· Protégé

Narrative Description:

3. States / VA Medical Centers Where Team Member Will Perform (Required per Section L‑2.5.5(3)) List all States, or specific VAMCs where this team member is expected to perform.

If multiple locations apply, list them all in this section.

4. Primary Construction Program Areas (Required per Section L‑2.5.5(4)) List all construction program areas this team member will support, such as:

· General healthcare facility construction and renovation,

· Healthcare additions and upgrades,

· Repairs, refits, maintenance enhancements, equipment and component replacement,

· Parking garages, parking lots, roadways, bridges,

· General office, conference, and meeting spaces,

· Requirements to maintain on-going operations and prepare for larger efforts such as swing space or make-ready work,

· Seismic retrofit of Existing facilities,

· Utilities to include but not limited to water, electrical, sewer, and storm water,

· Historic facility renovations,

· General infrastructure to include but not limited to fencing, vehicle barriers, awnings, and signage.

· Sustainable infrastructure requirements

· Medical equipment installation

· Technology infrastructure

· Security infrastructure

Enter all applicable areas below:

5. Teaming Agreement Reference (Required per Section L‑2.5.5 – all team members must have signed TAs)

Teaming Agreement File Name: _______________________________________ Date Signed: _______________________________