36C25621R0108 EXHIBIT C.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C25621R0108
About this file
This document contains a subcontractor consent form and details of a federal contract opportunity for WiFi expansion services. The opportunity is a 100% set-aside for service-disabled veteran-owned small businesses issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. Interested offerors must provide all labor, tools, materials and equipment to perform the work, which includes expanding WiFi access at the Gulf Coast Veterans Health Care System facility in Biloxi, Mississippi. The construction cost range is between $1 million and $2 million. The solicitation number is 36C25621R0108 and the NAICS code is 238210. The response due date is September 1, 2021 with an anticipated award date 30 days later. Subcontractors must complete a consent form to allow release of their past performance information to prime contractors.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25621R0108 0004.docx | DOCX document | |
| 36C25621R0108 0003.docx | DOCX document | |
| 520 22 161 Pre Award RFI Register 27 Aug 21 v2.docx | DOCX document | |
| VHA Directive 1193 COVID 2019 Vaccination August 13 2021.pdf | ||
| 36C25621R0108 0002.docx | DOCX document | |
| 36C25621R0108 0001.docx | DOCX document | |
| S04 Site Visit Sign-In Sheets - Proj 520-22-161.pdf | ||
| 36C25621R0108 WD MS20210050 04022021 Mod 2.docx | DOCX document | |
| 36C25621R0108 SOW.pdf | ||
| 36C25621R0108 EXHIBIT F.docx | DOCX document | |
| 36C25621R0108 ICRA .pdf | ||
| 36C25621R0108 Complete Drawings .pdf | ||
| 36C25621R0108 RFP.docx | DOCX document | |
| 36C25621R0108 EXHIBIT B.docx | DOCX document | |
| 36C25621R0108 EXHIBIT A.docx | DOCX document | |
| 36C25621R0108 EXHIBIT D.docx | DOCX document | |
| 36C25621R0108 Complete Specs.pdf | ||
| 36C25621R0108 EXHIBIT E.docx | DOCX document |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project 520-22-161 WiFi Expansion 36C25621R0108
EXHIBIT C – SUBCONTRACTOR INFORMATION AND CONSENT FORM
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 should be submitted to the offering contractor for submission with past performance volume.
Name of Firm: _________________________________
| (That is currently planning on participating as a subcontractor and or a teaming partner with) |
| Telephone:______________ |
Address:________________
City/State/Zip Code:_______
DUNS/Cage Code:__________________
Name of Prime:__________________________________
| (PRIME CONTRACTOR OR NAME OF ENTITY PROVIDING PROPOSAL in responding to the Request for Proposal No. 36C25621R0108 for Project WiFi Expansion) |
| Telephone:__________________ |
Address:____________________
City/State/Zip Code:___________
DUNS/Cage Code:____________
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
Reference List (required):
Contract No. And Title:
Describe role (Prime/Sub) and work Performed
Reference POC Name
Email address & Phone #
Contract No. And Title:
Describe role (Prime/Sub) and work Performed
Reference POC Name
Email address & Phone #
Contract No. And Title:
Describe role (Prime/Sub) and work Performed
Reference POC Name
Email address & Phone #
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