36C25621R0136 EXHIBIT C.docx
DOCX document 26 KB Posted
- Attached to
- Z1DA--520-19-117 Repair Water Supply
- Solicitation number
- 36C25621R0136
About this file
This document contains a subcontractor consent form and information related to a federal solicitation for repair work on a water supply system. The solicitation will be issued as a 100% set-aside for service-disabled veteran-owned small businesses to repair the water supply at the Gulf Coast Veterans Health Care System in Biloxi, Mississippi. The repair work is estimated to cost between $2 million and $5 million. Interested vendors must be registered and verified as a service-disabled veteran-owned small business in the Vendor Information Pages database. The tentative solicitation release date is August 6, 2021, with proposals due around September 6, 2021. The anticipated contract award date is approximately 30 days after proposal receipt. The base period of performance is 365 days from the notice to proceed.
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Other files
| File | Type | Posted |
|---|---|---|
| Pre-Award RFI Register 520-19-117 31 Aug 21.docx | DOCX document | |
| 36C25621R0136 0004.docx | DOCX document | |
| 36C25621R0136 0003.docx | DOCX document | |
| VHA Directive 1193 COVID 2019 Vaccination August 13 2021.pdf | ||
| 36C25621R0136 0002.docx | DOCX document | |
| S04 Site Visit Sign-In Sheet - Proj 520-19-117.pdf | ||
| 36C25621R0136 0001.docx | DOCX document | |
| 36C25621R0136 EXHIBIT E.docx | DOCX document | |
| 36C25621R0136 EXHIBIT D.docx | DOCX document | |
| 36C25621R0136 Drawings 1-4.pdf | ||
| 36C25621R0136 WD MS20210050 04022021 Mod 2.pdf | ||
| 36C25621R0136 EXHIBIT A.docx | DOCX document | |
| 36C25621R0136 Drawings 5-10.pdf | ||
| 36C25621R0136 RFP.docx | DOCX document | |
| 36C25621R0136 Specifications 01.pdf | ||
| 36C25621R0136 J_A.pdf | ||
| 36C25621R0136 EXHIBIT F.docx | DOCX document | |
| 36C25621R0136 EXHIBIT B.docx | DOCX document | |
| 36C25621R0136 Drawings 11-18.pdf | ||
| 36C25621R0136 SOW .docx | DOCX document | |
| 36C25621R0136 ICRA.pdf |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project 520-19-117 Repair Water Supply 36C25621R0136
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. 36C25621R0136 for Project 520-19-117 Repair Water Supply) |
| 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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