36C25622R0088 EXHIBIT C.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C25622R0088
About this file
This document contains a subcontractor information and consent form template for the solicitation numbered 36C25622R0088 to install signs and striping for garages at a Veterans Affairs medical center. Major subcontractors are requested to complete the form to consent to the release of their past performance information to the prime contractor. The form requires the subcontractor's name, address, DUNS/CAGE code, and signature of an authorized individual. It also requests a reference list including contract numbers and titles, the subcontractor's role, work performed, and points of contact with email and phone numbers for three past contracts. The related federal contract opportunity is for Project 629-18-115 to install signs and striping for garages through a construction solicitation issued by the Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16.
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Other files
| File | Type | Posted |
|---|---|---|
| RFI Register 06222022.docx | DOCX document | |
| 36C25622R0088 0003.docx | DOCX document | |
| 36C25622R0088 0002.docx | DOCX document | |
| Sign In Sheet.pdf | ||
| 36C25622R0088 0001.docx | DOCX document | |
| 36C25622R0088 ICRA-04092022.xlsx | XLSX spreadsheet | |
| 36C25622R0088 VHA Supplemental Contract Requirements for Combatting COVID-19.docx | DOCX document | |
| 36C25622R0088 BLDG 5- Patient Garage Drawings .pdf | ||
| 36C25622R0088 Updated Specs - 04272022.pdf | ||
| 36C25622R0088 EXHIBIT F.docx | DOCX document | |
| 36C25622R0088 WD LA20220011 Mod 1 02252022 .docx | DOCX document | |
| 36C25622R0088 RFP.docx | DOCX document | |
| 36C25622R0088 Visitors Phasing Plan.pdf | ||
| 36C25622R0088 EXHIBIT B.docx | DOCX document | |
| 36C25622R0088 EXHIBIT D.docx | DOCX document | |
| 36C25622R0088 EXHIBIT A.docx | DOCX document | |
| 36C25622R0088 Staff Phasing Plan .pdf | ||
| 36C25622R0088 Final SOW-04272022 .docx | DOCX document | |
| 36C25622R0088 EXHIBIT E.docx | DOCX document | |
| 36C25622R0088 BLDG 4- Staff Garage Drawings .pdf |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project 629-18-115 Install Signs and Striping for Garages 36C25622R0088
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. 36C25622R0088 for Project 629-18-115 Install Signs and Striping for Garages) |
| 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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