36C25622R0014 - Exhibit C Subcontractor Information and Consent.docx
DOCX document 44 KB Posted
- Attached to
- Z2DZ--Regular Construction Project: 520-22-102 Replace Multiple Flat Roofs, Biloxi Federal contract opportunity
- Solicitation number
- 36C25622R0014
About this file
This document contains a subcontractor consent form template for the solicitation number 36C25622R0014 to replace multiple flat roofs at the Biloxi Veterans Affairs facility. Major subcontractors are requested to complete the form to consent to the prime contractor discussing their past performance information with the government during the source selection process. The form requires the subcontractor's name, signature with authority to bind the company, reference contact information for up to three past contracts describing the subcontractor's role and work performed on each.
The related federal contract opportunity is for solicitation number 36C25622R0014 to perform project 520-22-102 replacing multiple flat roofs at the Biloxi VA facility. The solicitation is for regular construction work issued by the Department of Veterans Affairs Veterans Health Administration VISN 16.
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project 520-22-102 Replace Multiple Flat Roofs, Biloxi 36C25622R0014
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)
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 No. 36C25622R0014 for Project 520-22-102 Replace Multiple Flat Roofs, Biloxi
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) |
Company Name: Telephone #
Address:
City/State/Zip Code: Date:
Reference List (required):
| 1. | Contract No. And Title: | ||
| Describe role (Prime/Sub) and work Performed: | |||
| Reference POC Name | Phone: | Fax: | |
| Email address: |
| 2. | Contract No. And Title: | ||
| Describe role (Prime/Sub) and work Performed: | |||
| Reference POC Name | Phone: | Fax: | |
| Email address: |
| 3. | Contract No. And Title: | ||
| Describe role (Prime/Sub) and work Performed: | |||
| Reference POC Name | Phone: | Fax: | |
| Email address: |
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