EXHIBIT B - Subcontractor Information and Consent Form.docx

DOCX document 33 KB Posted

Attached to
Y1DZ--Design-Build Renovate 3rd Floor for Oncology & Telehealth
Solicitation number
36C24421R0013
Issued by

About this file

This document contains a subcontractor consent form and information on a federal contract opportunity for design-build renovation services. The subcontractor consent form allows for the disclosure of past performance information to prime contractors for the design-build renovation of the third floor for oncology and telehealth at the Erie Veterans Affairs Medical Center. The federal contract opportunity will solicit proposals for design and construction services with a performance period of 180 days and an anticipated value between $500,000 and $1 million. Only service-disabled veteran-owned small businesses will be considered in Phase I, with selection for Phase II involving additional evaluation factors. The work must comply with VA criteria and specifications and be completed by December 2022.

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

Exhibit B – Subcontractor Information and Consent Form

Each major subcontractor and/or Teaming Partner must also complete an Exhibit B, “Subcontractor Information and Consent Form” to be considered. Offerors shall have major subcontractors identify on the Exhibit A two references, owners (if they were the Prime) or other Prime contractors they have worked for. References for subcontractors from the proposing offeror are not acceptable. See Exhibit “A” format for information to be provided. Written references for subcontractors may be included and are encouraged; however, subcontractors do not need to send out past performance questionnaires.

A. Multiple Subcontractors may be named for the same discipline but is limited to a maximum of three (3) subcontractors per discipline.

B. Provide information regarding the assessment of liquidated damages on any contracts within the last five years. (Frequency, circumstances, severity of problem, etc.)

C. Offerors are strongly encouraged to include with their proposals information on problems encountered on relevant projects and the specific corrective actions taken to remedy the problems.

D. Other Past Performance Considerations. Information provided, shall be limited to the period starting 5 years prior to the solicitation release date.

a. -Effectiveness of value engineering (VEC) proposals you submitted on prior contracts. (Provide a brief description; impact on cost, schedule, efficiency or quality; contract number; name and phone number of customer benefiting from the VEC).

b. -Professional/Industry awards (Identify award type, date of award and copy of certificate if applicable), Letters of appreciation, recognition or commendations.

c. -Discuss unique skills and accomplishments (Explain unique skills and/or accomplishments and provide supporting information for verification).

Subcontractor and/or Teaming Partner Consent for the Release of Past Performance Information to the Prime Contractor and Reference Information:

Past performance information concerning subcontractors and teaming partners cannot be disclosed to a private party without the subcontractor’s or teaming partner’s consent. Because a prime contractor is a private party, the Government will need that consent before disclosing subcontractor/teaming partner past and present performance information to the prime during exchanges. In an effort to assist the Government in assessing your past performance relevancy we request that the following consent form be completed by the major subcontractors/teaming partners identified in your proposal. The completed consent forms shall be submitted to the offering contractor for submission with the past performance volume.

(Name of Firm) is currently planning on participating as a (subcontractor and or a teaming partner) with (prime contractor or name of entity providing proposal) in responding to the Request for Proposal Number 36C24421R0013, Project 562-18-407 Design-Build Renovate 3rd Floor for Oncology & Telehealth, Erie VA Medical Center, 135 East 38th Street, Boulevard, Erie, PA 16504, issued by Contracting Officer Paul Bosak.

We understand that the Government is placing increased emphasis on past performance in order to obtain best value in source selections. In order to facilitate the performance confidence assessment process, we are signing this consent form to allow you to discuss our past and present performance information with the prime contractor during the source selection process.

(Signature) (Title of Individual with authority to sign for and legally bind the company

Address:

City/State/Zip Code: Date:

Reference List (required):

1. Contract No. And Title

Describe your role (Prime/Sub) and work Performed

Reference POC Name Phone Fax

Email address:

2. Contract No. And Title

Describe your role (Prime/Sub) and work Performed

Reference POC Name Phone Fax

Email address:

3. Contract No. And Title

Describe your role (Prime/Sub) and work Performed

Reference POC Name_ Phone Fax

Email address:

Page 1 of Page 1 of

File details come from the government source that posted it. Updated .