36C25622R0062 EXHIBIT C.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C25622R0062
About this file
This document contains a subcontractor consent form and reference list for project number 667-19-101 to perform tuckpointing work at Building 1 of the Main Hospital. The project is being solicited by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. Major subcontractors and teaming partners are required to complete the consent form to allow their past performance information to be shared with any prime contractor responding to solicitation number 36C25622R0062. The form requests the subcontractor's name, address, DUNS/Cage code, and signature of an authorized individual. It also requires the subcontractor to provide a reference list including at least three past contract numbers and titles, their role as prime contractor or subcontractor, a description of work performed, and point of contact information for each reference.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25622R0062 SOW .docx | DOCX document | |
| 36C25622R0062 Part 7 DRWGS .pdf | ||
| 36C25622R0062 Part 6 DRWGS .pdf | ||
| 36C25622R0062 WD LA20220031 Mod 2 02252022.docx | DOCX document | |
| 36C25622R0062 ICRA .pdf | ||
| 36C25622R0062 EXHIBIT B.docx | DOCX document | |
| 36C25622R0062 Specifications.pdf | ||
| 36C25622R0062 EXHIBIT E.docx | DOCX document | |
| 36C25622R0062 COVID-19 Safety Protocols for Federal Contractors rev2 .docx | DOCX document | |
| 36C25622R0062 Part 8 DRWGS .pdf | ||
| 36C25622R0062 CRA .pdf | ||
| 36C25622R0062 EXHIBIT D.docx | DOCX document | |
| 36C25622R0062 Part 5 DRWGS .pdf | ||
| 36C25622R0062 Part 2 DRWGS .pdf | ||
| 36C25622R0062 Part 1 DRWGS .pdf | ||
| 36C25622R0062 RFP.docx | DOCX document | |
| 36C25622R0062 Part 4 DRWGS .pdf | ||
| 36C25622R0062 EXHIBIT A.docx | DOCX document | |
| 36C25622R0062 Part 3 DRWGS .pdf | ||
| 36C25622R0062 ILSM .pdf | ||
| 36C25622R0062 EXHIBIT F.docx | DOCX document |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 667-19-101 Tuckpoint BLDG 1, Main Hospital 36C25622R0062
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. 36C25622R0062 for Project No. 667-19-101 Tuckpoint BLDG 1, Main Hospital) |
| 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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