EXHIBIT B - Subcontractor Information and Consent Form.docx

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Attached to
Z1DA--Sterile Storage Improvements Construction Federal contract opportunity
Solicitation number
36C24426R0056
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 4

About this file

This is a Subcontractor Information and Consent Form (Exhibit B) for the Sterile Storage Improvements Construction project at Lebanon VA Medical Center. The form requires all major subcontractors and teaming partners to provide detailed information and obtain consent from subcontractors to release their past performance data to the prime contractor during source selection. Each subcontractor must identify two references from previous work (owners or other prime contractors, excluding references from the current proposing offeror), and up to three subcontractors per discipline are permitted. Offerors are required to provide information on any liquidated damages assessed within the past five years, including frequency, circumstances, and severity, along with details on problems encountered and corrective actions taken on relevant projects.

The form requests additional past performance considerations limited to the five-year period prior to solicitation release, including effectiveness of value engineering proposals with supporting contract details and customer information, professional or industry awards with dates and certificates, and documentation of unique skills and accomplishments. Subcontractors and teaming partners must complete a consent section authorizing the Government to disclose their past and present performance information to the prime contractor, and provide a required reference list with three entries including contract numbers, titles, descriptions of roles, and complete point of contact information. This documentation supports the Government's emphasis on past performance evaluation for achieving best value in the source selection process for the SDVOSB set-aside construction contract with a period of performance of 300 calendar days from Notice to Proceed.

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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 36C24426R0056 – Sterile Storage Improvements issued by the Department of Veterans Affairs, Lebanon VAMC 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:

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